Get answers to some of the most common questions and find in-depth information about obesity, how it impacts your health and various weight loss options.
Obesity
Obesity is a medical condition that occurs when a person carries excess weight or body fat that might affect their health.
A doctor will usually suggest that a person has obesity if they have a high body mass index.
- Genes and Culture
- Personal Health Choices
- Increased Calories Eaten
- Decreased Physical Activity
- Community and Environment
- Easy Access to High Calorie Foods
- Decreased Access to Physical Activity
Grade 1 overweight (commonly and simply called overweight) – BMI of 25-29.9 kg/m2
Grade 2 overweight (commonly called obesity) – BMI of 30-39.9 kg/m2
Grade 3 overweight (commonly called severe or morbid obesity) – BMI greater than or equal to 40 kg/m2
Yes, if a person does have obesity and excess weight, this can increase their risk of developing a number of health conditions, including metabolic syndrome, arthritis, and some types of cancer. Metabolic syndrome involves a collection of issues, such as high blood pressure, type 2 diabetes, and cardiovascular disease.
Body mass index (BMI) is a tool that doctors use to assess if a person is at an appropriate weight for their age, sex, and height. The measurement combines height and weight.
Yes, BMI allows healthcare professionals and patients to better understand health issues associated with a specific weight classification (classifications such as obesity and morbid obesity).
BMI between 25 and 29.9 indicates that a person is carrying excess weight. A BMI of 30 or over suggests that a person may have obesity.
Morbid obesity is diagnosed by determining Body Mass Index (BMI). BMI is defined by the ratio of an individual’s height to his or her weight. Normal BMI ranges from 20-25. An individual is considered morbidly obese if he or she is 100 pounds over his/her ideal body weight, has a BMI of 40 or more, or 35 or more and experiencing obesity-related health conditions, such as high blood pressure or diabetes.
People with BMI of 30-39.9 kg/m2 are called obese and people with BMI greater than or equal to 40 kg/m2are called morbidly obese
The causes of morbid obesity are multiple and complex. Despite conventional wisdom, it is not simply a result of overeating. Research has shown that, in many cases, significant, underlying causes of morbid obesity are genetic, environmental, and social. Studies have demonstrated that, once the problem is established, efforts such as dieting and exercise programs have a limited ability to provide effective long-term relief.
The key to controlling obesity isn’t short-term dietary changes. It is about a lifestyle that includes healthy eating and regular physical activity.
No, there is no single or simple solution to the obesity epidemic. It’s a complex problem and there has to be a multifaceted approach.
There are several methods for treating obesity, such as behavior modification, physical activity, non clinical weight management programs, medically managed weight-loss and surgical treatment.
Bariatric Surgery
Bariatric surgery is a procedure designed to make the stomach smaller so the patient feels satisfied with less food.
Any person who has:
- 100 pounds or more of excess weight; or a BMI of 40 or greater
- A BMI of 35 or greater with one or more co-morbid condition
Bariatric surgery procedures promote weight loss in one of three ways:
- Restriction, or limiting the amount of food you can eat before feeling full by reducing the size of the stomach.
- Malabsorption, or limiting the absorption of nutrients in the intestines by “bypassing” part of the small intestine (removing it from the path of food through the digestive tract).
- Combination of restriction and malabsorption
Bariatric surgery can improve the health and lengthen the life span of people who are severely obese.
Bariatric surgery procedures fall into three categories:
- Restrictive procedures make the stomach smaller to limit the amount of food Intake.
- Mapabsorptive procedures reduce the amount of intestine that comes in contact with food so the body absorbs fewer calories.
- Combination surgeries involved both restriction and malabsorptions.
Yes, Briatric surgery is safe. Patients needs to be fully assessed and found fit for anesthesia and surgery. There will be chances of general problems related to surgery in obesity. The problems are higher with higher BMI. Overall the chances of complications and chances of death will be less than 1%
Complications following bariatric surgery vary based upon the procedure performed. Some of the major complications of bariatric surgery are listed below:
- Fistula or Leaks
- Intestinal Obstruction and Internal Hernia
- Bleeding
- Wound Infections
- Stricture
- Pulmonary Embolism
- Anastomotic Ulcer
- Abdominal Wall Complications
- Rhabdomyolysis
- Nutritional Deficiencies
- Complications Specific to Gastric Banding
Complications following bariatric surgery vary based upon the procedure performed. Some of the major complications of bariatric surgery are listed below:
- Fistula or Leaks
- Intestinal Obstruction and Internal Hernia
- Bleeding
- Wound Infections
- Stricture
- Pulmonary Embolism
- Anastomotic Ulcer
- Abdominal Wall Complications
- Rhabdomyolysis
- Nutritional Deficiencies
- Complications Specific to Gastric Banding
No, weight loss surgery is not considered cosmetic. Though some patients may need cosmetic (plastic) surgery to remove excess skin, many surgeons recommend waiting until at least 18 months post op or maintaining a healthy consistent weight for 6 months, before proceeding with skin removal surgery.
Countless people would like to lose weight, but only those whose high weight poses a threat to their lives – the severely or “morbidly” obese – are considered viable candidates for undergoing bariatric surgery.
Patients who undergo bariatric surgery usually must completely transform the diet and activity habits they have spent a lifetime developing. Patients must not only adjust the frequency of meals and quantity of foods they eat but also learn to eat slowly and chew thoroughly. In addition, patients typically may need to take vitamin supplements for the rest of their lives.
There’s no specific age limit for gastric bypass surgery, but, studies have found gastric bypass surgery can be safe and effective for adults ages 60 and older. The procedure is also now considered an option for some teenagers with a BMI of 35 or more and serious obesity-related health problems.
Studies show that bariatric surgery can effectively improve and resolve many co-morbid conditions. A review of more that 22,000 bariatric surgery patients showed:
- Improvement in or complete resolution of conditions including type 2 diabetes, hypertension, and sleep apnea
- 61.2 percent reduction of excess weight maintained for 10 years or more
Pre-Surgery
People who have failed in their attempt to lose weight either by diet or exercise are considered as suitable candidates for the surgical process. If you are a person who:
- Has a minimum BMI of 40 for at least five years, or a minimum BMI of 35 with significant medical complications related to obesity.
- Are between the age of 18 and 65. Patients older or younger may be considered on a case-by-case basis.
- Show evidence of previous attempts to lose weight through a medically supervised program
yes, you may be a candidate for bariatric surgery.
The bariatric surgeon determines which of the following procedure will be appropriate for each patient:
- Adjustable gastric banding procedures: This procedure involves implanting an adjustable band that contains saline solution around the stomach to reduce its size. This surgery is reversible, causing no permanent change in patient anatomy. As the “Lap” part of the name suggests, it is usually performed laparoscopically (through a small incision).
- Vertical banded gastroplasty: Commonly known as stomach stapling, vertical banded gastroplasty is similar to the Lap-Band procedure in that the size of the stomach is physically reduced without interrupting a patient’s digestive process. This less reversible procedure, however, utilizes both a band and surgical staples—and the band is not adjustable.
- Sleeve gastrectomy: A restrictive stapling procedure, the sleeve gastrectomy removes a large portion of the stomach and transforms the shape of the remaining stomach from saclike to narrow and tubular. The surgery often can be performed laparoscopically.
- Roux-en-Y gastric bypass: During the procedure—which is often performed laparoscopically—surgeons use approximately 5 percent of a patient’s stomach to create a gastric pouch at the bottom of the esophagus. The pouch is connected directly to the middle part of the small intestine, bypassing not only the rest of the stomach but also the upper portion of the intestine, where some of the food’s calories are normally absorbed. The result is a “new” stomach about the size of an egg that continues producing the enzymes and juices necessary for digestion.
- Biliopancreatic diversion with duodenal switch (BPD/DS): BPD/DS surgery removes the lower section of the stomach, leaving a fairly large stomach pouch that is connected to the bottom part of the small intestine, called the distal ileum.
Contact our office directly to gather information on what insurance options might be available to you.
This depends on the insurance company.
The costs and additional costs vary depending upon the type of procedure, the patient and the surgeon.
About 40% of the person’s excess weight in 12-18 months. Provided the person follows the change in life style and avoids high calorie food.
It is recommended to wait 12 to 18 months after surgery before actively trying to get pregnant. Bariatric surgery improves chances of pregnancy. It helps in infertility management. Losing weight improves the overall chances of becoming pregnant.
Yes, patients are highly encouraged to stop smoking and take drugs at least three months before surgery. Smoking increases the risk of lung problems after surgery, can reduce the rate of healing, increases rates of infection, and interferes with blood supply to the healing tissues. It’s possible your surgery could be canceled if you don’t comply.
That’s a difficult question to answer, every patient is different, every patient’s motivation is different, and no two patients are going to have the exact same anatomy or outcome. If you have a minimum BMI of 40 for at least five years, or a minimum BMI of 35 with significant medical complications related to obesity, consult a doctor.
Yes, committing to bariatric surgery requires that you prepare ahead of time by eating a healthy diet and ensuring adequate levels of physical activity. Pre-surgery diet changes are needed to help you lose some of your excess body weight prior to surgery.
Potentially yes. As you lose weight you may be able to reduce or eliminate some of your medications. However, consult your prescribing physician before stopping any medications post operatively.
During your consultation with the surgeon, a plan for your operation will be developed. Based on this plan, the operation will be scheduled and a date for your hospital admission is decided. Your surgeon will decide when you are ready to leave the hospital, based on your progress.
Dr. Mohit Bhandari has the rare distinction of performing the highest number of bariatric and metabolic procedures in Asia Pacific region. If you are looking for a surgeon who pushes lifestyle before surgery, you have come to the right place. Dr. Mohit Bhandari will show you how you can lose fat and feel great. His goal is to make you leaner, healthier and happier.
Post-Surgery
You will likely go home the day after your surgery if your recovery signs are good.
The hospitalization period is normally 2-4 days and it will take about a week to get back to work. However, this varies from person to person.
Exercise is key to weight loss and weight maintenance after bariatric surgery. Start with fifteen to thirty minutes each day after surgery. Slowly add to your time to do sixty minutes or more each day.
Some doctors suggest a 2 week liquid diet, in the weeks leading up to surgery. And clear liquids only in the 24 hours prior to surgery. The liquid diet helps shrink your liver, helps reduce fatty tissue in the abdominal area, and gives better visibility to the surgeon during operation.
Ans. The daily intake of calories should be between 400 to 900 for at least 1 year after the surgery. And also, limit the fats, sweets and high calorie food items. The minimum intake of protein should be between 60 to 75 grams/day. The good sources of protein can be eggs, seafood, milk, soy, poultry, cottage cheese, fish, tofu, yogurt. After a year, the quality and variety of food can be increased but at the same time, it is very important to keep your body well-hydrated with at least 2 liters of fluids daily.
Ans. You will receive prescribed medication after the surgery. Some of them need to be taken for few months’ post-surgery and others need to be taken for life. You should take following supplements daily to prevent nutrient deficiencies.
- Multivitamin
- Calcium
- Vitamin D
- Vitamin B12
About 40% of the person’s excess weight in 12-18 months. Provided the person follows the change in life style and avoids high calorie food.
You may be required to walk the evening of your surgery. But, this is the doctor’s call.
Do not drive until after you stop taking pain medicine and are pain free for twenty-four hours.
Ans. It totally depends on your state of physical health before surgery. Most of the patients get back to work after two weeks of surgery with no activity restrictions.
Most bariatric surgery programs plan for long-term follow-up visits with a healthcare provider experienced with obesity management. These follow-up visits may be the surgeon, a physician assistant or nurse practitioner, dietitian, mental health professional, exercise specialist, or a medical weight-loss specialist (bariatrician).
Dr. Mohit Bhandari’s team is skilled professionals & experienced for bariatric surgery. Thorough preparation and follow-up programs we help you succeed in your weight loss mission. Our expert physicians have the ability to handle complex cases (for instance, people with certain liver problems or previous abdominal surgery). We also offer easy access to additional Medical Specialties. Our team and the state-of-the-art facility is specifically structured for the care of bariatric patients.