How Weight Loss Surgery Can Improve Your Health & Wellbeing

Imagine a Life Free from the Struggles of Obesity: Your Guide to Weight Loss Surgery

Imagine a life where every step feels like a struggle, and your breath hitches with every simple task. That’s the harsh reality for many living with severe obesity.

Struggling with obesity can be overwhelming, impacting daily life and long-term health. obesity-related comorbidities like heart disease, diabetes, and high blood pressure can significantly affect one’s quality of life. Weight loss surgery offers a lifeline to those battling not just the bulge, but a cascade of health problems that come with it.

It not only improves mobility by taking pressure off joints but also reduces the risk of associated health complications. For some, the most life-changing benefit is the effective management & control of type 2 diabetes, often happening soon after surgery.

Understanding Weight Loss Surgery

Weight loss surgery, also known as bariatric surgery, includes interventions such as gastric bypass and sleeve gastrectomy and offers a transformative approach to obesity management by modifying the anatomy of the stomach and small intestine. These interventions act on the body’s hormonal signaling system, influencing satiety (feeling of fullness) and hunger cues, while also impacting metabolic processes that regulate calorie intake. As a result, individuals experience a shift in their physiological makeup, facilitating significant and fast weight loss.

If you qualify for bariatric surgery, your weight loss surgeon and the healthcare team will determine the best surgical intervention for you and tailor a pre-surgery plan specific to your needs accordingly. Your pre-surgery preparation may involve:

Medical Checkups: Expect pre-operative lab tests and physical exams to establish your fitness levels for surgery.

Dietary and Medication Adjustments: You may receive instructions on what to eat and drink, and which medications (if any) need to be stopped or taken before surgery.

Exercise and Lifestyle Changes: Starting a physical activity program and quitting tobacco and alcohol might be crucial for a successful surgery and recovery.

Health Benefits of Weight Loss Surgery

Imagine shedding 70 to 80% of your excess weight and keeping it off for good!
Bariatric surgery offers impressive long-term success rates. Patients achieve substantial weight loss, shedding around 70 to 80% of their excess weight and keeping it off in the long term. Beyond the numbers, the impact is life-changing. Many report increased energy, reduced pain, and the ability to engage in activities they once struggled with. The rapid weight loss even triggers hormonal changes that further support weight management. Remember, consistency is key! Regular exercise and a healthy diet regimen after surgery play a crucial role in maintaining weight loss and newfound vitality.

Moreover, studies show a significant reduction in the risk of death from various conditions:

Heart Disease: Patients see a remarkable 40% decrease in their risk of dying from heart-related issues.
Diabetes: The risk of death from diabetes plummets by an impressive 92% after surgery.
Cancer: The chances of succumbing to cancer also see a significant 60% drop.

Well-being and Quality of Life Improvements

Diet-induced weight loss often isn’t sufficient nor sustainable, so health complications associated with obesity tend to persist.

Bariatric surgery offers a significant transformation that extends far beyond just weight loss. While significant weight loss is a key benefit, the true magic lies in the overall health improvements it unlocks. Patients report a surge in energy, a brighter outlook, and a newfound confidence that empowers them to fully embrace life. Activities that may have once been difficult or avoided become accessible, leading to a more fulfilling lifestyle.

The positive impact doesn’t stop there. Bariatric surgery becomes a catalyst for adopting healthier habits, including better food choices and regular exercise. This ripple effect often extends to loved ones, creating a supportive and healthy environment within families. Ultimately, weight loss surgery empowers patients to take control of their health, not just for the present, but for the long term. It’s a testament to the power of modern medicine in promoting a healthier, longer, and more fulfilling life.

Who Should Consider Weight Loss Surgery?

If you are trying hard to lose weight and/or have been battling weight-related complications, you might be wondering if weight loss surgery is a viable option for you. It is important to understand that Weight Loss Surgery is not a one-size-fits-all solution. Here’s a breakdown of who might be a good candidate for bariatric or weight loss surgery:

BMI above 32.5 kg/m2 with obesity-related co-morbidities
BMI above 37.5 kg/m2 without co-morbidities.
BMI > 30 kg/m2 with life-threatening obesity-related disorders like uncontrolled diabetes, cardiovascular disease/cardiomyopathy, and severe obstructive sleep apnoea.
Patients motivated to lose weight and are committed to long-term follow-up.
Patients who have unsuccessfully attempted conservative methods of weight loss in the past.
Weight Loss Surgery is to be considered only between the ages of 18 – 65 years.
Weight Loss surgery may be considered in patients more than 65 years old in case of severe obesity-related co-morbidities/disability.
Weight Loss Surgery may be considered in patients < 18 years in special situations as recommended by a trained pediatrician/endocrinologist, or after attainment of puberty/completion of skeletal maturity.

Weight Loss surgery is a life-changing procedure, and the surgeon you choose plays a critical role in your safety, success, and overall experience. Here’s why selecting a right bariatric surgeon is crucial:

Long-Term Support: A good bariatric surgeon offers comprehensive care beyond surgery. They will guide you through pre-operative education, support you during recovery, and provide long-term follow-up care. This includes nutritional counseling, managing potential side effects, and monitoring your overall health.
Understanding Your Needs: Not all bariatric surgeries are the same. A skilled surgeon will take the time to understand your individual needs, medical history, and weight loss goals. They should discuss the various bariatric surgery options available (gastric bypass, sleeve gastrectomy, etc.) and explain the advantages and disadvantages of each concerning your specific situation.
Experience Matters: Look for a surgeon who specializes in bariatric surgery and has a high volume of successful weight loss procedures under their belt. Experience translates to better surgical technique, improved efficiency, and a deeper understanding of potential complications and how to manage them.

Why Choose Dr. Atul Peters for Metabolic or Bariatric Surgery?

At Smart Cliniqs, we’re dedicated to your overall well-being, from the surgery itself to your post-operative recovery. Dr. Atul Peters, a renowned bariatric surgeon with over two decades of experience, has successfully performed numerous surgeries and is passionate about helping patients achieve their health goals. He leads comprehensive bariatric programs both locally and nationally, supported by a highly skilled team. Our global certification and active involvement in various National & International Surgical Societies underscores to our commitment to providing you with the best possible care.

Conclusion

While undergoing a weight loss surgery, you need to understand that results can vary, and long-term success requires a commitment from your side as well. Remember, obesity is a chronic condition, and additional treatments might be needed down the road. There are different surgical options with varying risks and benefits. Discuss these with your surgeon to see which weight loss surgery works for you.

References:

Understanding the Causes of Obesity in Children and Adolescents

Causes of Obesity in Children & Adolescents: Unraveling the Complex Factors

Recognizing the Growing Epidemic

According to the World Health Organization (WHO), children and adolescents from all walks of life, are increasingly facing the health threat of excess body fat, leading to overweight and obesity.

However, managing weight isn’t a quick fix; it’s a journey that requires lifelong support. The WHO emphasizes the importance of sustainable lifestyle changes that promote long-term well-being, not crash diets or rapid weight loss.

We used to think weight was simply about ‘calories in’ versus ‘calories out’, but science reveals a more complex picture. Genetics, environment, stress levels, emotional well-being, sleep patterns, underlying medical conditions, and even medications can all influence how our bodies store and manage fat.

Recognizing this complexity is crucial.

By addressing these multifaceted factors – behaviour, environment, and genetics – we can create a more effective and holistic approach to childhood weight management, paving the way for a healthier future for all.

Genetic Factors Contributing to Obesity

While we inherit a blueprint (genes) that influences weight, obesity isn’t just about our DNA. It’s a complex mix of factors. Genes can make some people more likely to gain weight, but hormones, metabolism, and even our culture and habits can all play a role in fat storage.

Even early in life, certain factors can increase a child’s chances of becoming obese. A mother’s weight before pregnancy, how much weight she gains while being pregnant, and even gestational diabetes (pregnancy-related high blood sugar) can all play a role. These factors can sometimes lead to a higher birth weight for the baby, which can independently be a risk factor for obesity, later in life. Additionally, a family history of weight issues, diabetes, high blood pressure, or certain hormonal problems can also increase a child’s risk of being overweight.

The good news? …Even with a genetic nudge, healthy choices like diet and exercise can make a big difference.

Dietary Habits and Nutrition

Childhood obesity may be linked to certain dietary habits. One major contributor is the overconsumption of calorie-dense foods that are low in essential nutrients. This includes things like processed snacks, fast food, and sugary drinks. These types of foods are often heavily marketed to children, making them even more appealing. While the research is ongoing on the exact impact of other dietary factors like snacking frequency, meal skipping, or one’s eating speed, it’s clear that an overall healthy diet plays a crucial role in weight management for young people.

Shedding extra kilos through calorie restriction (dieting) may be an effective strategy in the short term, but it’s important to consider how our bodies respond over time. While dieting offers a jumpstart, our bodies adapt to changes in calorie intake. This adaptation can sometimes involve a slowdown in metabolism, making it trickier to maintain weight loss in the long run.

Physical Activity Vs Sedentary Lifestyle

Children tend to become less active as they grow older, with a dip seen around age 6 and another around 13. This is especially more true for girls than boys. Children who are overweight or obese tend to move less throughout the day compared to their thinner peers. There’s also a general trend of children spending more time sitting as they get older.

Catching those Zzzs is important for more than just feeling well-rested! Studies have established a direct link between sleep habits and weight gain in children. Children or adolescents who don’t get enough quality sleep, whether it’s due to shorter sleep duration, restless sleep, or going to bed too late, seem to be at a higher risk for obesity. This might be because insufficient sleep is associated with being less active, having unhealthy eating habits, and even developing insulin resistance.

Screen time could also play a role. Too much screen time can disrupt sleep patterns and potentially mess with hormones that control hunger and fullness. Think of it as a domino effect: less sleep can lead to cravings for unhealthy foods and less energy for exercise, which can contribute to weight gain.

Psychosocial and Economical Factors

Weight stigma, the societal devaluation of people who are overweight or obese, can be a major psychosocial factor contributing to obesity. Negative stereotypes paint them as lazy and lacking willpower, creating a discouraging environment. This stigma manifests as bullying and social rejection, especially for children, impacting their mental health and self-esteem. The stress and negativity can even lead to disordered eating behaviours, making weight management even harder. Feeling ashamed and less motivated to participate in social activities due to weight stigma can further hinder progress. This cycle of negativity and discouragement creates a significant barrier to healthy lifestyle changes for those struggling with weight.

Building on the complex challenges of weight management, obesity also carries a significant cost burden. Not only does it strain healthcare systems financially, but it also has a profound impact on individual and societal well-being. The long-term nature of obesity means managing weight requires sustained commitment and lifestyle changes. This burden, coupled with psychosocial factors like weight stigma, can create a discouraging cycle that makes weight management even more difficult.

Environmental and Socioeconomic Influences

Our surroundings strongly influence how we live and our health. Modern life has become less active. Cars replaced walking, technology replaced exercise, and quick meals replaced healthy cooking. This makes it easy to fall into unhealthy habits like eating poorly and not getting enough exercise. As a result, we consume more calories than we burn, leading to weight gain.

The obesity spike in recent times is largely due to the surrounding environment that promotes weight gain.
This can happen at the family level (habits modelled by parents), community level (access to parks, healthy food options, and safe walking areas), or even national policies (government food subsidies or marketing practices). These influences can take advantage of our biological, psychological, social, and economic vulnerabilities.

Prevention Strategies and Early Intervention

Helping children and adolescents with obesity requires a multi-faceted approach. The goal is to reduce excess body fat, improve health problems related to weight, and prevent the development of chronic diseases in the future.

Treatment typically integrates a combination of different components. This may include learning healthy eating habits with the help of a nutritionist, incorporating regular physical activity into the child’s routine, and providing psychological support to address any emotional challenges associated with weight. In some cases, medication might be prescribed to assist with weight management.

Metabolic and bariatric surgery offers the best long-term results for weight loss in severely obese adolescents.
Studies show significant weight reduction (25-40%) even years after procedures like Roux-en-Y gastric bypass or sleeve gastrectomy.

The benefits go beyond weight loss!

Individuals often see improvement in health problems linked to obesity, like cardiometabolic risk factors, musculoskeletal pain, and functional mobility.

References:

showPdf (thelancet.com)

What is obesity? (bomss.org)

Obesity – American Society for Metabolic and Bariatric Surgery (asmbs.org)

https://www.atulpeters.com/blog/obesity-children-adolescents/

Can Lack of Sleep Cause Obesity?

How Lack of Sleep Contributes to Obesity and Weight Gain

There are many possible ways that lack of sleep could increase the chances of becoming obese. Obesity develops when energy intake is more than depletion. Diet and physical activity play an important role in this, but in addition, inadequate sleep may also be an equally important factor. Unfortunately, many people are not getting enough sleep.

Sleep-deprived people may be too tired to exercise or may take in more calories than those who do, clearly because they are awake longer and have more chance to eat. It’s not that if you sleep, you will lose weight, but if you are not getting enough or good quality sleep, your metabolism will not function properly.

Not getting enough sleep is common, even talked about with pride by some people, but we do pay a price for staying up late and getting up early.

Less sleep makes you more likely to eat more calories at night, your appetite increases and you are less likely to resist eatables and control portions which may lead to weight gain.

Poor food choices combined with lack of physical activity set the stage for obesity and further sleep loss.

Poor sleep completely alters the way the body responds to food.

On the other hand, starting healthy sleep habits can help your body maintain a healthy weight.

Tips for Better Sleep

Here are a few tips to keep in mind to get a good night sleep:

1. Avoid any caffeine late in the evening

2. Exercise also helps improve sleep quality.

3. Turn off all electronics – no screen time before bed

4. Make sure your bedroom is dim and quite

5. Have a bedtime routine – try to go to bed the same time daily, your body gets used to a schedule

6. Avoid big meals before bedtime – can increase the risk of heartburn, which will certainly keep you up all night.

Suffering from obesity? Looking for obesity surgery in Delhi? Schedule your appointment with us at Smart Cliniqs.

Also Read: Understanding the Causes of Obesity in Children and Adolescents

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.

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 28^th 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:

laparoscopic sleeve gastrectomy,

laparoscopic roux-en-y gastric bypass, and

laparoscopic mini gastric bypass.

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!

Can Malnutrition cause obesity?

How Malnutrition Can Cause Obesity: Insights from Top Bariatric Surgeons

Obesity is a multi-factorial disease; it simply means that, no single cause which can be solely attributed to it. It is also well known that scientists do not know exactly what exactly causes weight gain. Often, we all see people who can eat whatever comes their way and they still remain thin. With the exception of these lucky few, we are programmed to gain weight with age.

According to top bariatric surgeons, it is a matter of the balance between what you eat, and how much you spend. If we consume calorie-dense food regularly and don’t burn those extra calories, we are likely to gain weight. But can malnutrition cause obesity?

Surprisingly yes.

Obesity Surgeons who treat obese teens know that children who were underweight at birth are prone to gain too much weight in their childhood and adolescence. Children who faced food shortages during famines later on developed abdominal obesity, the classic Indian Subcontinent profile of thin people with paunch, the so-called thin- obese in medical jargon. As we know that the tummy fat or abdominal obesity is the medically worst. This fat is the harmfully active type that leads to diabetes, heart disease, and cholesterol disorders, the so-called metabolic syndrome.

Malnutrition means not eating right; right food at the right time. People who starve for too long to lose weight are initially successful in losing some weight, but complex hormonal reactions result in weight regain, overshooting the earlier weight. This is known Yo-Yo dieting. Secondly, prolonged fasting slows down our metabolism and stops losing further weight, and starts regaining on the same diet. We tend to lose more muscle mass than fat during the starvation phase and fail to regain our muscle back. So with each dieting cycle of malnutrition, we lose more and more muscle mass and gain more fat.

Starvation or fasts followed by eating calorie-rich low protein food ultimately results in further weight gain and obesity. The best bariatric surgeons know well from their experience that protein-deficient diets after bariatric surgery are counterproductive in the long run and patients may end up regaining all their weight.

Malnutrition can really make us obese.

Still confused that malnutrition can cause obesity? Visit us at Smart Cliniqs and learn more about obesity.

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.