Obesity is a disease where excess body fat has accumulated to the extent that it may adversely affect health.
The Body Mass Index (BMI), calculated as weight (in kilograms) divided by the square of height (in metres), is the recommended index to define obesity.
Classification of BMI in Asian adults.
Risk of co-morbidities
18.5 to 22.9
23 to 27.4
Obese Class I
27.5 to 32.4
Obese Class II
32.5 to 37.4
Obese Class III
Patients who are morbidly obese (obese class III) have a much-reduced life expectancy compared to people of normal weight.
Weight reduction can be achieved through various measures such as diet therapy, physical activity, behaviour therapy, and pharmacotherapy.
Bariatric Surgery, as part of a multi-discipliary approach is the most effective method for helping severely obese patients reduce weight.
[Colquitt JL , Pickett K , Loveman E , Frampton GK . Surgery for weight loss in adults . Cochrane Database Syst Rev 2014 : CD003641.]
There are different types of bariatric/weight loss procedures. They include
Energy imbalances which causes the body to store fat
Some medical conditions such as hypothyroidism
The Body Mass Index (BMI), calculated as weight (in kilograms) divided by the square of height (in metres), is the recommended index to define obesity. Weight loss surgery should be considered for the treatment of obesity for acceptable Asian candidates with BMI ≥ 35 with or without other medical conditions. (IFSO-APC Consensus Statements 2011)
Although every surgical procedure will carry with it a certain amount of risks, weight loss surgery has been found to be one of the safest elective operations.
The three main types of weight loss surgery are gastric bypass, sleeve gastrectomy and adjustable gastric banding. Each of these procedures has different risks and potential weight loss. The choice of the procedure will depend on the individual patient’s factors such as coexisting medical conditions, BMI, expectations, etc.
You can lose between 20-25% of the total body weight at 5 years after the operation. The results will vary between patients. The amount of weight loss will also depend on how strictly you follow the dietary and lifestyle modification advice given.
Weight loss surgery for obesity alone is generally not covered by insurance in Singapore. However, some insurance plans may provide coverage for treatment of obesity-related medical conditions.
There is a staged approach to the dietary recommendations after weight loss surgery. The progression will be from liquids, pureed foods, and soft foods to solid foods. After 3 months, most patients can tolerate a regular diet comprising of small meals.