Obesity is a disease where excess body fat has accumulated to the extent that health may be adversely affected.
The Body Mass Index (BMI), calculated as weight (in kg) divided by the square of height (in metres), is the recommended index to define obesity.
Classification of BMI in Asian adults
|Category||BMI||Risk of co-morbidities|
|Normal weight||18.5 to 22.9||Average|
|Pre-obese||23 to 27.4||Increased|
|Obese Class I||27.5 to 32.4||Moderate|
|Obese Class II||32.5 to 37.4||Severe|
|Obese Class III||>37.5||Very severe|
Patients who are morbidly obese (obese class III) have a much reduced life expectancy compared to people of normal weight.
Weight Management Strategy
Weight reduction can be achieved by various measures such as:
However, conservative treatment fails in more than 95% of morbidly obese patients.
Bariatric surgery, as part of a multi-disciplinary approach, is the most effective method that
helps the severely obese patients to reduce weight. Patients with a Body mass index (BMI) of > 37.5 kg/m2 and BMI > 32.5 kg/m2 (for Asians) with significant obesity related co-morbidities. They have failed non-surgical treatment (such as diet, exercise and drug treatment), are fit for surgery and agree to lifelong follow up and lifestyle changes.
The various surgical options can be classified into the following categories: restrictive procedures, malabsorptive procedures and combined restrictive/malabsorptive procedures. Restrictive procedures limit the patient’s ability to take in food whereas malabsorptive procedures interrupt the digestive process.
Weight loss surgery is performed under general anaesthesia. They include adjustable gastric banding, sleeve gastrectomy and roux-en-Y gastric bypass.
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