Tag: bariatric surgery

Pre-Op Liver Shrinking Diet

The Liver Shrinking Diet: Essential Pre-Surgery Guidelines for Bariatric Patients

(FOR WEIGHT LOSS SURGERY 800 – 1000 CALORIES A DAY)

Patients need to follow this liver shrinking diet for the 14 days immediately before the surgery. It will reduce the fat and glycogen stored in your liver, make the liver smaller and allow the surgeon to perform the operation safely.

This diet is ONLY recommended before surgery and should NOT be followed at any other time as it is too restrictive.

  • Have three meals a day and use the ‘extra’ fruit or yoghurts as desserts or as snacks.
  • Try to vary the foods as much as possible during the fortnight to help make sure you are getting a good range of nutrients. It may be a good idea to start having the multivitamin and iron supplement (that you are recommended to take after surgery) while you are on this restricted diet.
  • Do not guess weights – use scales to measure portions accurately.
  • No sugar, cooking oils, margarine, butter, low-fat spread, mayonnaise or sauces are allowed.
  • The following drinks and flavourings are allowed freely: Water, tea and coffee (using milk from allowance), low calorie squash.
  • A small amount of the following can be added to food if needed: salt, lemon juice, vinegar, balsamic vinegar, garlic, herbs and spices, pepper, artificial sweeteners
  • Include at least 2 litres (4-5 pints) of fluid a day.

Breakfast

30g non-sugar-coated and nut-free cereal e.g. porridge oats, ready brek, bran flakes, rice crispies, special K, cornflakes, shreddies, sultana bran. OR 1½ weetabix or shredded wheat OR 1 portion of fruit OR 1 diet yoghurt OR 1 small slice of bread or roll.

Lunch and Dinner

1 small slice of bread or small roll or 2 crispbreads or 100g potato (uncooked weight) – jacket, boiled or mashed with milk from allowance, or 30g (uncooked weight) of rice, couscous, pasta or noodles.

With

100g of vegetables OR cereal bowl of salad with 1 teaspoon of low-calorie dressing (no salad cream or mayonnaise)

With

Choose ONE of the following – all are cooked weights:

150g steamed or poached fish (No batter or breadcrumb coatings) OR 50g lean meat (Trim off all fat before cooking) OR 1 large egg eg poached, boiled or scrambled with milk OR 110g Quorn or Tofu OR 25g cheese eg. cheddar, brie, stilton etc. OR 50g low-fat soft cheese eg. Philadelphia light, Laughing Cow light etc. OR 75g chicken or turkey OR 100g tinned tuna/pilchards (not in oil) OR 50g tinned salmon/sardines (not in oil)

Each day also includes:

260ml (½ pint) of skimmed or semi-skimmed milk

2 portions of fruit (one of which could be swapped for a small (150ml) glass of fruit juice)

1 diet/light/virtually fat-free yoghurt or from age frais

A portion of fruit is:

1 large fruit eg. banana, apple, pear, orange, grapefruit OR 2 small fruits eg. kiwi, plum, satsuma

OR 200g strawberries, raspberries, blueberries, blackberries, rhubarb or gooseberries OR

10 grapes or cherries, OR 100g tinned fruit in juice

Preparing for bariatric surgery? Get your liver shrinking diet plan prepared by us at Smart Cliniqs by the top nutrition counselor in Delhi.

Benefits of Losing Weight

The Comprehensive Benefits of Weight Loss: Health, Lifestyle, and Social Gains

If you are overweight or obese and planning to lose weight, it’s important to understand the benefits of losing weight. Actually, weight loss has to be pleasing or it isn’t sustainable. You are either stressed or relaxed. Anything stressful will give you a stress response. Find things that are enjoyable and use it to construct a healthier lifestyle.

Every weight loss plan falls apart at the seams at some point. Therefore, to set yourself up for favorable outcome, understanding the extended weight loss benefits that help to keep you motivated after Bariatric Surgery (Weight loss surgery) include Health benefits, lifestyle benefits, and social benefits. There are different approaches to losing weight depending on your BMI and health issues. A BMI greater than 32.5 with one or more significant obesity-related medical conditions or a BMI 35 and above can be taken up for Bariatric Surgery (Weight loss surgery).

Diet and exercise would work for people with a BMI less than 32.5 but beyond this Bariatric Surgery (Weight loss surgery) is recommended for realistic, sustainable, and long-term results. This also means that surgery is more likely to improve the health conditions connected to obesity.

Health Benefits of Losing Weight

  • Lowers the risk of some types of cancers
  • Lowers the risk of / resolves Diabetes
  • Decreases the risk / resolves Hypertension
  • Improves / resolves Lipid profile
  • Reduces / resolves backache
  • Improves Fertility
  • Reduces the symptoms of Arthritis (Osteoarthritis)
  • Lowers the risk of Cardiovascular disease
  • Improves breathing
  • Reducing the risk of Kidney disease
  • Decreases risk of / resolves Sleep Apnea
  • Reduces risk of a weak bladder (in women)
  • Decreases/resolves Joint pains Reduces symptoms of Gastric Reflux
  • Reduces the risk of Stroke
  • Reduces the risk of varicose vein or DVT
  • Improves mobility

Your doctor will inform you more information about the health benefits you can expect when you lose weight. He may also recommend a dietician and physical activity post Bariatric Surgery.

Lifestyle Benefits of Losing Weight

  • Better Hormonal Imbalance
  • Better Sleep
  • Clearer and brighter skin
  • Increased sexual performance
  • Improved memory
  • Active social life
  • Stress relief
  • More confident
  • Improves vitality
  • Better wardrobe
  • Less medications
  • Better mood
  • Improves energy level

For many people, their weight defines how they feel about themselves. Our body image states how we connect with others, and our confidence, and it affects how healthy we feel going about our daily lives. Apart from the medical benefits of weight loss, you will also experience an improved lifestyle.

Social Benefits of Weight Loss

  • More comfortable in your body
  • Moving around is easier
  • Satisfaction of knowing you look your best
  • You can focus on improving yourself in other ways
  • Decreases the perspiration levels
  • Being confident in a group

The social benefits of weight loss are mostly very substantial short-term motivators. However, these incline to be less potent at sustaining long-term lifestyle change because they often are geared towards short-lived events, such as some social function. Positive changes in lifestyle that are not externally imposed may more likely be able to sustain themselves over time.

Enjoying the Benefits of Weight Loss

If you decide that there are significant reasons for you to lose weight, then there’s no time like the present to start your weight loss journey. Our physique dictates how we feel about ourselves and that lightens up our confidence. Your first step should be to set a reasonable goal. Then make small changes to your daily routine and eating habits.

Suffering from being overweight and wanna lose weight through bariatric surgery? consult us at Smart Cliniqs as we have the team of the best bariatric surgeons in Delhi.

What is Bariatric Surgery? Risk, Complications, and Side Effects

What is Bariatric Surgery? Understanding Gastric Bypass and Its Benefits

Bariatric Surgery or weight loss surgery is done to help you lose excess weight by making changes to your digestive system. 

Gastric bypass is one of the most common types of bariatric surgeries or weight loss surgeries being performed all over the world. Gastric bypass surgery is also done to reduce your risk of life-threatening weight-related health problems, including:

  • Type2 Diabetes Mellitus
  • Heart disease
  • High blood pressure
  • Severe sleep apnea

The Gastric bypass and other weight-loss surgeries are typically done only after you’ve tried to lose weight by improving your diet and exercise habits.

In general, gastric bypass and other weight-loss surgeries could be an option for you if:

  • Your body mass index (BMI) is 40kg/m2 or higher.
  • Your BMI is 35 to 40 kg/m2 and you have a serious weight-related health problem,
    such as type 2 diabetes, high blood pressure, or severe sleep apnea. In some
    cases, you may qualify for certain types of weight-loss surgery if your BMI is
    30 to 34 and you have serious weight-related health problems.

This surgery requires permanent changes to lead a healthier lifestyle and long-term follow-up plans that include monitoring your nutrition, your lifestyle and behavior, and your medical conditions.

Risks of Gastric Bypass Surgery:

Risks associated with the surgical procedure are few and rare. They might include:

  • Excessive bleeding
  • Infection
  • Blood clots in your legs
  • Lung or breathing problems
  • Leaks in your gastrointestinal system

All the above-mentioned risks and complications can be identified early and taken care of only at a high-volume and experienced center with staff specially trained in Bariatric Surgery.

Long-term risks and complications of weight-loss surgery vary depending on the type of surgery. They can include:

  • Bowel obstruction
  • Dumping syndrome, causing diarrhea, nausea, or vomiting
  • Gallstones
  • Hernias
  • Low blood sugar
  • Malnutrition
  • Ulcers
  • Vomiting

After gastric bypass and other types of weight-loss surgery the diet begins with liquids only, then progresses to ground-up or soft foods, and finally to regular foods.

You’ll also have to undergo frequent and regular medical checkups to monitor your health in the first several months after weight-loss surgery. You may need laboratory testing, blood work and various exams at fixed intervals to monitor the nutritional profile.

You have to keep all of your scheduled follow-up appointments after weight-loss surgery. It is mandatory to see your doctor immediately for any unusual symptoms or complications. You don’t need to weigh yourself frequently. Weight is monitored by the bariatric nurse and dietician at regular intervals. You might not lose enough weight or regain weight after any type of weight-loss surgery, even if the procedure itself works correctly. This weight gain may be due to loss to follow-up or excessive liquid calorie intake. To help avoid regaining weight, you must make permanent healthy changes in your diet and get regular physical activity and exercise, and follow all the instructions by your bariatric dietician.

Looking for bariatric surgery in Delhi? At Smart Cliniqs, we provide the best bariatric surgery in Delhi. Consult with us today!

Do I qualify for bariatric surgery?

Growing Importance of Bariatric Surgery: How to Qualify for Bariatric Surgery

Growing Importance of Bariatric Surgery

Since, progressive generations are growing heavier with increased association with other metabolic disorders – diabetes, hypertension, and dyslipidemia. There has been an increasing role of bariatric surgery in the management of obesity and its associated co-morbidities. Technological leaps in the field of Laparoscopic Bariatric Surgery as well as Robotic Bariatric Surgery have led to the evolution of bariatric surgery from a major, uncommon, and often dangerous surgery with doubtful outcomes to a much safer, routine procedure with assured results.

Evolution of Bariatric Surgery Criteria

Initially, it was a difficult task to elect candidates who could undergo bariatric surgery. In 1991 the National Institutes of Health (NIH) consensus statement for the first time defined clear universally acceptable criteria for patient selection. This statement was revised and re-defined as more and more data began to be analysed subsequently. The cut-off BMI to undergo surgery was lowered over a period of time.

Types of Bariatric Surgery

Starting with Gastric Bypass surgery, in which Roux-en-Y gastric Bypass being the gold standard, nowadays Gastric Sleeve Surgery is becoming more and more popular among surgeons since it is relatively simple to perform with similar post-operative outcomes.

Shift from Weight Loss to Metabolic Surgery

With the understanding of the metabolic syndrome, of which obesity was just one part, there was increasing interest in the role of surgery in the resolution of co-morbidities, particularly diabetes and dyslipidemia.

The increasing incidence of diabetes and cardiovascular disease even at lower BMIs, particularly in specific populations such as Asians led to a demand to consider these surgeries for selected candidates with low BMIs also. The emphasis shifted from ‘weight loss’ surgery to ‘metabolic’ surgery. It was suggested that perhaps action points for Asians should be 2.5 BMI points lower i.e. at 32.5 and 37.5.

New Eligibility Criteria and Recommendations

With this background, the International Diabetes Federation (IDF) released a position statement on 28th March 2011 supporting surgery to treat Type II diabetes in obese patients. It defined new lower BMI criteria for patient selection as explained in the table below.

Eligibility and prioritization for bariatric surgery based on failed non-surgical weight loss therapy +, BMI, ethnicity ++, and disease control.

BMI range Eligible for surgery Prioritised for surgery
< 30 No No
30 – 35 YES – Conditional +++ No
35 – 40 YES YES – Conditional +++
> 40 YES YES

+ In all cases, patients should have failed to lose weight and sustain significant weight loss through non-surgical means, and have type II diabetes that has not responded adequately to lifestyle measures (+/- metformin) with HbA1c < 7%.

++  Action points should be lowered by 2.5 BMI points for Asians.

+++ HbA1c > 7.5 despite fully optimized conventional therapy, especially if weight is increasing, or other weight-responsive co-morbidities not achieving targets on conventional therapies.

Impact and Endorsements

The new recommendations significantly lowered cut-off BMIs making many more patients eligible for surgery. Theoretically, an Asian patient with a BMI as low as 27.5 could be a candidate for metabolic surgery, provided other conditions are met. This is a significant shift from the previously recommended cut-offs.

These have received widespread attention in the medical community and have been endorsed by several medical bodies – The American Heart Foundation (AHA), the American Medical Association (AMA), The American Society of Metabolic and Bariatric Surgeons (ASMBS), and The American Association of Clinical Endocrinology (AACE).

Confused if you qualify for bariatric surgery or not? Consult us at Smart Cliniqs and we will schedule your appointment with the best bariatric surgeon in Delhi.

Side Effects of Bariatric Surgery

Understanding the Side Effects of Bariatric Surgery: What You Need to Know

Overview of Bariatric Surgery

Bariatric surgery is increasingly being accepted as a viable option for treating morbid obesity and its associated diseases such as diabetes mellitus and hypertension. Surgery provides long-term sustained weight loss as well as resolution of co-morbid conditions.

The benefits of bariatric surgery are numerous but there are also a few risks and side effects associated with various bariatric surgical procedures.

Common Bariatric Procedures in India

The most common bariatric surgical procedures performed in India are:

Immediate Side Effects of Bariatric Surgery

There are a few immediate side effects that can happen after bariatric surgery like bleeding, leak, intestinal obstruction, and venous thromboembolism. The side effects due to malnutrition or undernutrition are seen in the long term, particularly after laparoscopic gastric bypass surgery.

The incidence of bleeding is less than 4% in patients undergoing bariatric surgery. Most cases can be managed by blood transfusions alone. Some cases might require laparoscopy to stop the bleeding. A leak from the anastomosis site or sleeve staple line occurs in about 0.7% to 5% of the patients. If the leak is early, re-laparoscopy with identification of the leak and its closure is done with adequate drainage, bowel rest, and antibiotics.

Similarly leaks after a mini gastric bypass can be managed early by drainage and conversion of the procedure to Roux-en-Y gastric bypass along with a feeding tube in the intestines. The other rare immediate problem can be that of wound infection which is managed by dressing and antibiotics. Obesity is an independent risk factor for thromboembolism which is the clotting of blood in the veins of the body particularly the legs. This is best avoided by taking heparin injections for the first few days after the surgery and wearing graded pressure stockings for a few weeks. Early active mobilization is the best precautionary method.

Long-Term Side Effects and Nutritional Deficiencies

Lately, there can be obstruction of the intestines due to various factors which result in pain and distension of the abdomen along with vomiting. The possible causes usually are smoking, and the formation of ulcers. This can be identified by doing an endoscopy or a CT scan. Treatment of the possible causes can be done immediately.

After bariatric surgery, iron, vitamin B12, and other micronutrient deficiencies can occur.  Iron deficiency occurs in patients within 2 to 5 years after surgery. Supplementation with iron can reduce iron deficiency significantly. Calcium and vitamin D absorption are impaired after gastric bypass as well. We obtain a complete blood count and iron, B12, calcium, folic acid, vitamin D, levels before surgery, 6 months and 1 year after surgery, and yearly thereafter. We recommend routine daily supplementation with a multivitamin, iron, vitamin B12, and calcium along with vitamin D supplementation depending on the serum levels.

Dumping Syndrome

Dumping syndrome is a common side effect after Roux-en-Y Gastric Bypass (RNYGB) surgery. This usually occurs due to poor food choices. It is related to the ingestion of refined sugars (including high fructose corn syrup) or high glycemic carbohydrates. It can also occur with dairy products, some fats, and fried foods.

The fact is that these foods will interfere with long-term weight loss and should not be eaten anyway.

Symptoms start typically 20-30 min after the food. It includes sweating, flushing, lightheadedness, tachycardia, palpitations, desire to lie down, upper abdominal fullness, nausea, diarrhea, cramping, and active audible bowel sounds.

Conclusion

In summary, although bothersome and sometimes worrisome, dumping syndrome is not a life-threatening problem. Patients need to learn about and read basic nutrition labels. The benefit is that it teaches patients quickly that certain foods and additives cannot be tolerated. Patient compliance and commitment to long-term follow-up are mandatory.

In short, the side effects of bariatric surgery are rare. Timely
identification and intervention are the keys to preventing serious complications.

Still confused about bariatric surgery? Then schedule your consultation with the top bariatric surgeon in Delhi at Smart Cliniqs.

Obesity in Metros

Addressing the Growing Concern of Obesity in Metros: Causes and Implications

Obesity is a medical condition when a person carries excessive weight. It increases the risk of various non-communicable diseases like type 2 diabetes, hypertension, etc. For weight maintenance, energy intake should be equal to energy expenditure. Imbalance leads to underweight and obesity.

Adults residing in Metropolitan cities are increasingly becoming obese. Even Childhood obesity is also emerging as a major health concern in metros. The reasons being excess consumption of calorie-dense fast food, processed food, ready-to-eat food, etc. Portion sizes that fast food restaurants offer contribute to excessive energy intake. As most of the fast foods are made of refined cereals, fat, and sugar. There is a drastic decrease in energy expenditure owing to reduced physical activity as people use motorized means of transport and spend most of their awake time sitting glued to Television, mobile phones, and Laptops. The present work culture in the corporate and public sectors is also responsible for obesity in adults. Long working hours, late night shifts, sitting jobs, sleep deprivation, excessive tea and coffee consumption, and unhealthy snacking in offices predispose obesity.

Obesity surgery in India is being performed to facilitate weight loss in children and adults when non-surgical treatment strategies fail.  Although GI surgeons and general surgeons in India are performing obesity surgery specially trained bariatric surgeons are now available. Bariatric surgery is growing as a specialty in itself. as surgery constitutes only a small part in overall management. A fully equipped, and well-staffed department is a must for the dedicated follow up which is so essential for good outcomes. A dedicated high-volume Bariatric surgery unit in a tertiary care hospital is your best bet if you are seeking bariatric surgery.

Are you Seeking obesity surgery in Delhi or want to more about obesity in metros? Consult with us today at Smart Cliniqs!

Bariatric Surgery Hospital in Delhi

Choosing the Best Bariatric Surgery Hospital in Delhi for Effective Weight Loss

Delhi is the popular destination for medical tourism. Patients from every corner of the world come to Delhi, India for bariatric surgery. Many hospitals in Delhi are currently performing the surgery. Bariatric surgery hospitals in Delhi are specialized centers with trained and expert surgeons and specialized paramedic staff. In Delhi, both private and government hospitals are performing bariatric surgery. To name a few, private hospitals like Indraprastha Apollo hospitals, Max Healthcare, BLK super specialty, Fortis, Medanta hospital are performing bariatric surgery in Delhi. Premier government hospitals like All India Institute of Medical Sciences (AIIMS), Ram Manohar Lohia (RML), Lok Nayak Hospital (LNJP) are also performing bariatric surgeries.

Roux-en-y- gastric bypass surgery is the “gold standard” procedure. It refers to a type of bariatric surgical procedure in which the stomach is divided into a small pouch and then the small intestine is rearranged and connected to the newly created pouch. Roux-en-y- gastric bypass surgery is used to promote weight loss and also improve weight related issues like type 2 diabetes, hypertension, high cholesterol, arthritis, sleep apnea, infertility, hypothyroid, joint pain, backache etc.

Obese patients have a compromised vitamin and mineral intake due to excess energy consumption. Drastic weight loss post roux-en-y-gastric bypass surgery compounds the already present vitamin and mineral deficiencies. Patients who undergo Roux-en-y-gastric bypass surgery should attend regular follow-up sessions with a registered dietician so that deficiencies could be identified and treated at an early stage.

Behavioural Disorders in Obese: Important to Evaluate before WLS

Addressing Behavioral Disorders in Obese Patients: The Role of Laparoscopic Bariatric Surgery

Laparoscopic Bariatric Surgery and Its Effectiveness

Laparoscopic Bariatric surgery is one of the most effective treatments of morbid obesity, resulting in significant and sustained weight loss as well as improvement of various other related co-morbidities and quality of life.

Prevalence of Psychosocial Disorders in Morbidly Obese Individuals

Along with all other co-morbid conditions like Type 2 Diabetes Mellitus, Hypertension, and PCOD, etc., the prevalence of psychosocial disorders, including suicidal behavior, as well as substance abuse or eating disorders, is quite high among morbidly obese individuals.

Importance of Psychiatric Evaluation Before Bariatric Surgery

That is why, while evaluating for bariatric surgery, a psychiatric evaluation of individuals undergoing bariatric surgery is a must nowadays, since one might miss a pre-existing mental illness leading to inadequate treatment before and after surgery.

Factors Contributing to Suicidal Behavior Post-Surgery

Some of these issues like lack of physical activity before and after surgery, lack of improvement in quality of life, persistence or recurrence of sexual dysfunction, and history of ill-treatment in childhood might contribute to suicidal ideas if not assessed preoperatively.

High Expectations and Potential Disappointments Post-Surgery

These patients might have very high expectations of body appearance post-operatively and might be disappointed by the physical outcomes of the surgery. Sometimes weight regain might also lead to suicidal behaviors.

Increased Alcohol Sensitivity Post-Bariatric Surgery

It has been found that after bariatric surgery, the alcohol sensitivity of certain individuals might rise. Alterations in the GI tract after surgery lead to altered absorption of alcohol. It has been seen on several occasions that certain individuals continue alcohol consumption after surgery. Therefore all candidates of bariatric surgery are counseled and educated about the ill effects of alcohol after bariatric surgery and to minimize the use of it.

Compulsive Eating Disorder and Its Persistence Post-Surgery

When undergoing the dietary pattern of morbidly obese patients, there is a high prevalence of compulsive eating disorder. These problems can also persist after bariatric surgery. Few patients may develop ‘loss of control’ eating, and even self-induced vomiting. These conditions are associated with less weight loss and increased fear of weight regain.

Importance of Comprehensive Follow-Up Programs

According to Dr. Atul NC Peters, one of the pioneers of weight loss treatment in Delhi and among the top 10 obesity surgeons in India, it is important that such follow-up programs are developed, that address these types of problems focusing on psycho-social factors as well as eating disorders for a successful outcome.

Obesity in Children and Adolescents

Addressing Obesity in Children and Adolescents: Causes, Risks, and Effective Interventions

The prevalence of obesity is increasing in both children and adolescents, in both sexes and in various ethnic and racial groups.

Many factors, including genetics, environment, metabolism, lifestyle, and eating habits, are believed to play a role in the development of obesity. However, more than 90% of cases are idiopathic; less than 10% are associated with hormonal or genetic causes.

Defining Obesity in Childhood and Adolescence

There is no single definition of obesity in childhood and adolescence.

Consensus committees all over the world have concluded that children and adolescents be considered overweight or obese if the BMI exceeds the 85th or 95th percentiles, on curves generated from the 1963-1965 and 1966-1970 NHANES, or exceeds 30 kg/m2 at any age.

Energy Intake and Sedentary Lifestyle

During childhood and adolescence, excess fat accumulates when total energy intake exceeds total energy expenditure. Reduced energy expenditure is attributed to modern-day sedentary lifestyles. This is particularly associated with excessive television viewing, excessive computer use, and insufficient physical activity. Also, this is often seen when feedings are supplemented with additives such as carbohydrates or fat.

Hormonal Dysfunction and Familial Obesity

Some hormonal dysfunction like that in ghrelin leptin hormonal axis may be the causative factor in as many as 10% of obese children, particularly in those who appear to manifest familial morbid obesity.

Race and ethnicity are also associated with increased rates of obesity in children and adolescents.

Childhood Obesity as a Predictor of Adult Obesity

Childhood obesity is predictive of adult obesity such as with 80% of teenagers who are obese continue to be obese as adults.

This is associated with an increased incidence of type 2 diabetes, hypertension, gallstones, and hypercholesterolemia.

Chest Conditions Associated with Childhood Obesity

There are serious chest conditions associated with childhood obesity like reactive airways, poor exercise tolerance, increased work of breathing, and increased oxygen consumption.

They might develop obesity-hypoventilation syndrome and experience right-sided heart failure with right ventricular hypertrophy.

Acute Complications of Childhood Obesity

Acute complications of childhood obesity include hyperlipidemia, accelerated growth and bone maturation, ovarian hyperandrogenism and gynecomastia, cholecystitis, pancreatitis, and pseudotumor cerebri.

  • There is an increased incidence of fatty liver and they might develop liver cirrhosis and kidney disease.
  • Obstructive Sleep apnea and sleep-disordered breathing are common in children and adolescents with obesity which might lead to neurocognitive dysfunction.
  • Excess weight in children can cause numerous orthopedic disorders, including genu valgum, slipped capital femoral epiphysis, with bowing of the long bones.
  • Emotional and psychosocial sequelae are also widespread in obese children.
  • Social isolation, peer problems, and lower self-esteem are frequently observed.
  • Gout and colorectal cancer rates are found to be increased among men who had obesity as adolescents as well as arthritis.

Therapeutic Interventions for Childhood Obesity

Any therapeutic intervention in the child with obesity in aimed to achieve control of weight gain and reduction in body mass index (BMI) safely and effectively and to prevent the long-term complications of obesity in childhood and adulthood.

These might also require psychiatric assistance for unusual eating disorders or severe depression. It involves a team involving nurse educators, nutritionists, exercise physiologists, and counsellors.

Parental Involvement and Lifestyle Changes

Parents must advice children to walk at least 20 to 30 min daily. Limit their television timings and must indulge in vigorous exercise with children. Low-calorie balanced diet, in association with patient and parent education, behavioral modification, and exercise can limit weight gain in many patients with mild or moderate obesity. Reductions in total and saturated fat may be particularly useful in adolescents who consume large quantities of high-fat, snack, and packaged fast foods, including french fries, pizza, chips, and crackers. Also, they might sometimes require and care if evidence of psychopathology or dysfunction is present.

Bariatric Surgery for Childhood Obesity

According to Dr. Atul NC Peters, one of the pioneers of weight loss treatment in Delhi and among the top 10 obesity surgeons in India, various bariatric surgical procedures have been performed in “carefully selected” patients with a body mass index (BMI) >40 kg/m 2 who have severe comorbidities such as nonalcoholic fatty liver disease. It is important to consider several other factors before deciding whether a child or adolescent should undergo bariatric surgery like previous attempts at weight loss, and ability to adhere to follow-up care. Laparoscopic sleeve gastrectomy is the most widely performed procedure in childhood obesity nowadays.

Evidence suggests that bariatric surgery can decrease the grade of steatosis, hepatic inflammation, and fibrosis in Non-Alcoholic Fatty Liver Disease. With more and more people opting for various bariatric surgical procedures, weight loss surgery cost in Delhi has been such that it is becoming affordable day by day and several finance and loan schemes are also available in special circumstances.

Bariatric Surgery in Delhi

The Rise of Bariatric Surgery in Delhi: A Comprehensive Solution for Obesity and Type 2 Diabetes

Increasing Prevalence of Obesity

There is a dramatic increase in prevalence of obesity. The traditional approaches like dietary and lifestyle modification, physical activity, and pharmacotherapy fail to facilitate weight loss and treat obesity. So, bariatric surgery is the most sustainable treatment option. Bariatric surgery also promises improvement in obesity-related comorbidities like type 2 diabetes, hypertension, dyslipidemia, arthritis, etc. so, the term bariatric surgery is now replaced with bariatric and metabolic surgery. These days metabolic surgery for diabetes has emerged as a proven tool for the resolution or control of type 2 diabetes. This weight loss treatment in Delhi is being done only at specialized centers, by adequately trained and expert surgeons. Thus it gives a permanent cure to this traditionally regarded as a progressive, unrelenting disease called type 2 diabetes.

Bariatric Surgery in Delhi

In the last few years, there has been an increase in weight loss treatment in Delhi. Many centers are currently performing bariatric surgery. Patients from every corner of India prefer to come to Delhi for bariatric surgery owing to the availability of the best medical facilities, trained and experienced bariatric surgeons, and specialized paramedic staff. Even International patients prefer Delhi, India for bariatric surgery.
Sleeve gastrectomy and roux-en-Y gastric bypass are the most commonly performed weight loss procedures. Metabolic surgery for type 2 diabetes targets patients with uncontrolled diabetes who are currently on oral drugs and insulin. Scientific literature reports that bariatric and metabolic surgery results in weight loss, improvement/ normalization of blood sugar levels, reduction/ withdrawal of diabetes medications, and decrease in cardiovascular disease risk factors. It is a simple procedure and the patients may be able to leave the hospital in one day or even the same day in selected cases.

Comparing Surgical Procedures

In patients with reflux disease and type 2 diabetes, the results of sleeve gastrectomy may be inferior to the roux-en-Y gastric bypass but the excess weight loss of both the procedures may be comparable in a select subgroup of patients.

Nutritional Considerations Post-Surgery

Nutritional deficiencies are present in obese patients as consumption of a high-energy diet compromises on protein, vitamin, and mineral intake. As Sleeve gastrectomy and roux-en-Y gastric bypass involve removal or bypassing of some parts of the stomach and /or small intestine, so, macronutrient (protein) and micronutrient deficiencies (calcium, iron, B12, vitamin D, folate, etc.) are very likely to occur post-operatively in the patients. Nutritional assessment remains the key component pre-operatively and post-operatively to identify, prevent, and treat nutritional deficiencies at an early stage. Nutritional assessment involves taking physical measurements of the body (height, weight, etc.), analyzing blood and urine samples, identifying deficiency signs and symptoms, and performing a comprehensive dietary assessment.

Ensuring Surgical Success

Consuming a well-balanced energy-restricted diet with vitamin and mineral supplements and timely follow-up with the bariatric team promises success of the surgery.