obesity panel

OBESITY: DANGER OF BEING OVERWEIGHT

On a one of a busy routine day in August 2003, I received a call from Dr Prem, an ENT surgeon from Kerala stating that he wants an appointment for a consultation. I spoke to him and advised him to come on a date, which was convenient for both of us. I presumed that the appointment was probably for one his relatives and that he would be accompanying them during their visit to Coimbatore. To my surprise, I learnt that he was obese and he had already decided to opt for surgical treatment for improvment of his condition. He explained to me that he was suffering a lot due to this problem and he was finding it increasingly difficult even to perform the day to day routine activites like bending down to tie the shoe laces, sitting down of the floor and was experiencing problems even in his sexual life. Being a doctor and surgeon himself, he had understood well about his condition and knew about the possible complications of this disease. He exhausted all the weight reducing measures like crash diet, exercises and others. Even though he was able to achieve a small reduction in weight, he found it extremely difficult to maintain the weight loss. He would gain weight within in a very short period of time.

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Having decided to undergo surgical treatment for obesity he scanned through the medical literature and web to know about the various surgical options for the treatment of obesity. He came to a conclusion that the gastric bypass was the most suitable surgery for him and laparoscopic method was the most successful, safe and less invasive method when compared to the open surgery. He had learnt about our hospital from on of his doctor friends in Bangalore and wanted to undergo the operation under me. When he informed me about the facts I explained to him that had not yet performed a laparoscopic bariatric surgery by then. He insisted that I should perform the surgery as he was completely confident about my laparoscopic surgery skills and maintained that I was the only surgeon in India from whom he would get operated on for a surgery like this. I explained him about the merits of the demerits of the surgery and operated him on August 2003. The laparoscopic gastric bypass surgery proceeded smoothly and I discharged him within few days. When I called him to find about his recovery during the first week, he said was performing a surgery and would call me back after the procedure was over. I could realize the benefit of laparoscopic surgery then. If it had been an open procedure he would have stayed in the hospital for more than 15 – 20 days and would take a moth or two for the recovery (if the recovery was smooth without any complications). Now, he has lost almost 45 kilos since surgery (initial weight was 115 kilos) and still continuing to do so and more importantly the surgery has changed his life completely. Now he is able to perform routine activities like any other person and was extremely happy that he had undergone the procedure at the right time. This was my first laparoscopic bariatric surgery and following that I have performed more than 20 of these procedure in my hospital. Recently we operated on an American citizen from New York for obesity at our centre. Our centre is an accredidated centre for laparoscopic training by the Society of American Gastrointestinal Endo Surgeons (SAGES).

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Recently I performed this procedure on a 22-year-old young male form Aryialur, who was 200 kilos in weight. He underwent through various dieting schedules, nature cures, drugs and even plastic surgery without any significant improvement. He had undergone fat reduction surgery (lipectomy – removal of fat from abdomen and breast region) a couple of years ago. Though he had lost weight initially he gained more than 40 kilos after the procedure and was still putting on weight. He was included in a weight reduction programme along with a group of similar individuals (two of them were sons and daughters of a important persons in the Tamil film industry) by a leading corporate hospital in one of the Metros. He had been told that the hospital had planned to invite a American surgeon to perform the procedure on all these individuals in the due course of time. He came to me after learning about my centre and

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we evaluated him thoroughly and operated him a couple of weeks before. In fact we had to re equip our theater with entire new set of instruments including the operating table and the cots in the intensive care unit to accommodate his massive weight. After seeing these types of cases and receiving continuous queries about these procedures, I realized the magnitude of this problem in our country. Due to the changing life style, eating habits and Westernisation of our culture we are seeing more number of these cases at present. I thought that it would be pertinent on my part to share the facts about obesity,
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its complications and the various types of treatment that are available at present and the ways and means of prevention of development of obesity. I have presented the answers to various doubts asked by my patients regarding obesity and bariatric surgery.