All about obesity

Pizzas, pastas, burgers, butter chicken, - it seems that the list of indulgences are never ending, nor is their availability. Along with the efficiency of home and office delivery, the seemingly never-ending hours spent perched behind a computer screen, and the results are bound to show, and where else but on our bodies? The signs are telling, we have less energy, clothes seem to fit a little snugger as the days pass, sleep doesn’t relieve the fatigue, and the problem only continues to grow. The rising rates of obesity has become a hot topic across the globe, but with having noticed the problem, there are more efforts and qualified professionals responding to it as well.

‘Obese’ is a term that describes someone who is very overweight with an immense excess of body fat that may impact other parts of an individual’s health. “The impact of obesity is huge over the community,” says Dr. Hussam Al Trabulsi, General & Bariatric surgeon from Medcare Hospital “in fact it is a leading cause of world mortality, morbidity, disability, healthcare utilisation and healthcare costs. Obesity can be caused by different reasons such as: family history and genes, lifestyle habits, eating behaviours and stress can contribute to obesity.”

When it comes to obesity in children, it is advised to conduct hormonal tests as well as genetic tests to rule out any chromosomal abnormalities.  Other times, adult obesity is stemmed from poor habits formed during childhood, transforming an obese child into an obese adult.

The risks and impacts of obesity is most prominent in causing major health problems, especially type 2 Diabetes, where 85% of obese people are likely to be diagnosed. Diabetes which is when sugar and glucose levels rise in the blood, can cause blindness, oversensitive and painful nerves, as well as a rise in heart problems. Obese individuals are also at a higher risk for cancer, skin diseases, and osteoporosis.

Body Mass Index (BMI)
When it comes to assessing whether you are overweight or obese the most commonly used method is the Body Mass Index. The BMI measures both sexes and all ages of adults. The BMI measures your weight to your height and produces a score. Generally, a score of 18.5 to 24.9 means you're a healthy weight, 25 to 29.9 means you're overweight, and over 30 means medically obese.

Another measure of obesity is by waist circumference, this can also be used for people who are overweight says Dr. Mazin Rasool Aljabiri at Mediclinic “generally, men with a waist circumference of 94cm (37in) or more and women with a waist circumference of 80cm (about 31.5in) or more are more likely to develop obesity-related health problems.”

Managing Obesity
Obesity, much like other diseases can be controlled. This will require a long-term commitment from the individual and an overall lifestyle change. The prime reason for stored body fat is when the intake of calories supersedes the calories used and burned through physical activity. Children are recommended 60 minutes a day of excercise, while adults should aim for 150-300 minutes across the week.

If you fall under the obesity spectrum on the BMI scale, addressing the concern with your General Practitioner and Dietician are also key steps to take.

Medical approaches to weight loss
Many people who struggle with severe obesity may have surgical and non-surgical options available to lose weight depending on their individual circumstance and patient basis.

One temporary and non-surgical method is the Gastric Balloon System. “In 20 minutes, a silicon balloon is inserted into the stomach endoscopically, without incisions or surgery. It is a one-day procedure and the patient can actually go home within two hours.” explains Dr. Muffi from Dr. Muffi’s Centre for Advanced Surgery. The Gastric Balloon System is used on patients with a BMI of 27 or above and has been successful granting some patients to gradually lose between 10-15kg and up to 18-20kg over the course of six months. Another non-surgical procedure is Gastric Botox in which a gastric injection is performed to relax the muscles of the stomach thus causing it to contract less. It also works by blocking a key nerve in the stomach that controls hunger.

Weight loss surgery
According to Dr. Muffi, bariatric and weight loss surgeries are recommended for individuals with grade 3 obesity and those that fall in the grade 2 and suffer from one or more other illness such as sleep apnea, type-2 diabetes, mellitus and hypertension.

There are a range of common surgeries that doctors offer to patients. Dr. Shakeel Ahmed is an Internal Medical specialist at ICARE clinic, Mankhool branch, he says the most common surgery is the laparoscopic gastric bypass in which the surgery causes patients to feel full after eating a small amount of food. Sleeve gastrectomy is another common procedure, again restricting portions that the patient can eat, thus enabling them to lose weight. There is also the option of a gastric band, in which a band is placed around the stomach.

Pre and Post surgery facts 
“All these operations can lead to significant weight loss within a few years, but each has advantages and disadvantages” says Dr. Mazin Rasool Aljabiri, Consultant Physician & Gastroenterologist from Mediclinic City Hospital.

Advantages of surgery
“In general, gastric bypass patients will lose around 70 percent of their excess weight, sleeve gastrectomy patients will lose around 60 percent and gastric banding patients will lose around 50 percent” said Dr Shakeel Ahmed, Internal Medical specialist from ICARE Clinic, Mankhool branch.

“The health risks of bariatric surgery are much lower than the health risks of obesity itself. The patient will be back at a desk job within two weeks and four weeks for physical work after bariatric surgery. Most people lose half their extra weight during the six months they prepare for surgery and the rest over six to 12 months after surgery.” said Dr. Hussam Al Tarabulsi, General & Bariatric Surgery from Medcare hospital.

Disadvantages of surgery 
“Being left with excess folds of skin, you may need further surgery to remove these, not getting enough vitamins and minerals from your diet, you'll probably need to take supplements for the 
rest of your life after surgery.” said Dr. Mazin Rasool Aljabiri, Consultant Physician & Gastroenterologist from Mediclinic City Hospital.

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