Obesity can lead to hypertension, diabetes mellitus, heart attacks and brain strokes. Here’s everything you need to know about obesity.
Health Tips: Obesity and undernutrition are high risks for premature death and disability. According to National Family Health Survey (NFHS) 2016, 10% has fallen under-nutrition level. This had led to an increase in the frequency of obesity. This can lead to hypertension, diabetes mellitus, heart attacks and brain strokes.
Dr. Aparna Govil Bhasker, Consultant Bariatric and Laparoscopic Surgeon, Saifee, Apollo Spectra, Namaha and Currae Hospital, Mumbai, shares valuable and answers questions that revolve around obesity.
- I hardly eat anything. Why am I still gaining weight?
This is one of the most common questions that we get during our weight loss consultations. Many people with a weight issue do not have a big appetite. Ironically, many people with a big appetite may also not have a weight issue. We see such people around us all the time. Obesity is a multifactorial condition. Food intake is just one part of it. Almost 70% of obesity is genetic in origin. The other determinants of weight gain are neurohormonal factors, appetite regulation and energy balance, metabolic adaptation, sleep and stress-related factors, level of physical activity, environmental factors. Quantity of food intake matters and is one of the modifiable factors in the management of obesity but it is not the sole cause for weight gain.
- I have great willpower. I lose a lot of weight every time I put in effort, but whenever I stop the program, the weight comes rushing back. How can I cure obesity?
This sounds familiar. We all go through the same cycle. Maintenance of weight loss is the biggest challenge and most people end up regaining weight over a period of time. The faster the weight loss, faster it is to, come back. Crash diets are the easiest to crash. Hence it is important to understand the nature of the disease. Obesity is a chronic condition that needs long term monitoring and support. Diet and lifestyle modification, drug therapy, endoscopic therapies and bariatric/metabolic surgery may be needed in various permutations and combinations depending on the clinical profile of the patient and severity of the disease. Patients and their treating clinicians must understand that to be able to keep the weight under control, escalation of therapies along with regular counseling effort will be needed from time to time. Obesity cannot be cured, but it can be controlled effectively with good guidance from a qualified weight loss specialist.
- How effective are endoscopic weight loss therapies? Are they the same as bariatric surgery?
Off late there has been a lot of focus on the newer endoscopic therapies. They are a welcome addition in the armamentarium for our battle against obesity. Endoscopic therapies include the balloons (conventional endoscopic balloons and the newer Elipse balloon) and the endoscopic sleeve gastroplasty. These therapies are usually bridge therapies and meant for patients with grade 1 or grade 2 obesity.
Do they lead to the same results as bariatric surgery? The answer to that is “no”. Bariatric surgery is meant for patients with grade 3 obesity or those who need to lose 30 kg and above in terms of weight loss. Endoscopic therapies alone may fall short of achieving these weight loss goals in patients with grade 3 obesity and may be recommended only if patients are medically unfit for surgery. Every therapy has its place in the treatment pyramid and will give the best results only when performed for the right group of patients.
- Is bariatric surgery covered by insurance?
Yes, bariatric/metabolic surgery is now covered by insurance companies. You can avail of cashless cover or reimbursement if you fulfill the qualifying criteria as per your company. Every company has a set of criteria in terms of waiting period which is usually 3 to 4 years. In general, if your BMI is above 40 Kg/m2, and the surgery has been recommended by a medical professional, you may be eligible for insurance coverage. If your BMI is above 35 Kg/m2 along with two other co-morbidities like diabetes or hypertension etc, it can also be considered for insurance.
