There are two types of Obesity:

1. Android or apple-shape obesity
2. Gynoid or pear-shape obesity

This fat distribution is determined genetically & varies among men & women. Android obesity is more common among males whereas females are more susceptible to gynoid obesity. The android obesity is linked to chronic ailments such as glucose intolerance, insulin resistance, hyperlipidemia & hypertension. This type of obesity is also closely associated with the development of metabolic syndrome (a complex of unified conditions like glucose intolerance, high blood pressure and alterations in serum lipids).

Lower Quality of Life:

Social, psychological and financial effects of obesity are a reality and can be particularly devastating. Obesity is associated with lower quality of life. Obesity impairs physical, emotional and social functionality. Many overweight people often face judgment and discrimination. They become depressed and/or defensive and cannot live life to the fullest. Overweight people must adjust to daily problems, from finding clothes that fit and look good to finding a comfortable way to travel and live. In addition, daily activities become tiring and hard to perform. Overweight people also face social stigma when seeking work or education. They are routinely considered less qualified for a job or as someone with a poorer work ethic, emotional problems or problems with interpersonal relationships.

Indications for Obesity Surgery

• Is Bariatric Surgery the right solution for my patient?
• 30 kg overweight or a BMI> 33 kg/m2 for more than 5 years with at least one comorbidity (ASIA PACIFIC GUIDELINES)
• BMI > 37 with or without co-morbidities
• Failure of sustained weight loss on supervised dietary and conservative approaches (OR Multiple unsuccessful attempts at weight loss with non-surgical methods) - Absence of an endocrine cause (Secondary obesity). Acceptable operative risk
• Compulsive eaters
• Compliant patient, who demonstrates willingness to maintaining dietary guidelines and other follow-up care.
• Those who have support from family, spouse, or close friends.
• Surgery is not recommended for the mentally ill or impaired, patients known to abuse alcohol or drugs, or those with an eating disorder such as bulimia.

If the answer to the above is yes, then you should advise to seek the opinion of a Bariatric expert.

Only a surgeon specialised in bariatric surgery may determine whether someone is a suitable candidate. The general requirements for Indian population are:

• BMI ≥ 37.5
• BMI 32.5 coupled with several obesity- related health problems.
• Previous unsuccessful attempts to lose weight under medical supervision (i.e. - diet, exercise, medication)
• Underlying illness causing weight gain. (hormonal conditions)
• Will to make a life-long commitment to follow- ups and to follow the extensive dietary, exercise and medical guidelines
• No medical or psychological obstacles to surgery or the use of anaesthesia
• No alcohol or drug abuse.
• Quitting smoking at least 6 weeks prior to surgery