Brochure_obesity
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Ramanathapuram, Coimbatore - 641 045
International Center of Excellence
& RESEARCH CENTRE
in
Obesity and
Diabetes Surgery
Tel: 0422 - 2325100, Fax: 0422 - 2320879
Obesity is a medical condition in which excess
Unlike most disease, Obesity doesn't have a single cause; there
Obesity is rarely just a physiological problem. This disorder has far
body fat has accumulated to the extent that it
are several. Recent research suggests that the rise in obesity is
reaching effects; physiological, psychological and social. On the
may have an adverse affect on health. It is a life-
primarily due to altered, sedentary lifestyles, high calorie diets
physical front, obesity can lead to several complications that could
long progressive, life threatening disease
and reduced physical activity secondary to globalisation,
be fatal or incapacitating if left untreated.
which can significantly reduce life expectancy.
Some of the most common causes of obesity are as follows:
Some of the most common diseases that are directly and
When weight reaches extreme levels, it is
indirectly linked to obesity are:
called MORBID OBESITY which is prone to
It has been scientifically shown that heredity influences the
You are here, only because you are
develop numerous medical, psychological and
distribution of fat tissue. Moreover, weight regulation in the
not happy with the way you are, be
social consequences.
human body depends upon various genetically determined
factors such as hormones. Any abnormality in these factors could
it the way you look or the way you
It can be defined based on the Body Mass
result in substantial weight gain. Almost 60% of obese people
Index into various categories as shown below.
live. Isn't it? And you definitely
are said to have inherited this condition. There are several
BMI Classification:
genetic conditions that also contribute or lead to weight gain.
know the solution for this is not
BMI = w + (kg) / [ht (m)]
But this more often blamed as the cause, and these are definitely
simple too. It requires a multi
BMI is a useful general guideline and is a good
modality care. For this we need
estimator of body fat for most adults between
19 and 70 years of age
In rare cases, some may develop obesity secondary to certain
therapists from different aspects like
hormonal disorders. This includes diseases like Cushing
However, it may not be an accurate
the nutritionist, lifestyle therapist
syndrome, hypothyroidism, hypogonadism in men and
measurement of body fat for body builders,
polycystic ovarian syndrome in women and hypothalamic
and a medical professional
certain athletes, and pregnant women
lesions like tumours.
dedicated to treat Obesity and
Healthy weight is defined as BMI equal to or
greater than 19 and less than 25
Diabetes and related diseases. What
Certain drugs like steroids, sulfonylureas for diabetes, steroidal
BMI greater than or equal to 25 is overweight
contraceptives and antiepileptics such as valproate may cause
if all these people are within one
weight gain. Antipsychotics, antidepressants, mood stabilizers
BMI greater than or equal to 30 is obesity
roof. And the result - GEM
like lithium are also known to possess the same properties. Even
BMI ≥ 35 or 40 is severe obesity
certain unapproved medications for weight loss may cause
Obesity Diabetes
Surgery Centre.
increase in weight and hence not recommended.
BMI of ≥ 35 or 40 - 44.9 or 49.9 is morbid
Psychological Causes
This is a speciality at GEM since
Depression is most often associated with binge eating and may
2003 with more than 1000
A BMI of ≥ 45 or 50 is super obesity
lead on accumulation of weight. The relationship between
Obesity is also defined by waist size - over 90
obesity and one's emotional set-up is now widely recognized.
Obesity surgeries being done so far,
cm in males and over 80 cm in females.
Over time this becomes a repetitive process and eventually leads
and now we have made this
With every single increase in BMI, the chances
speciality an exclusively dedicated
of developing diseases like Diabetes,
The food inflation may be high but still the world today is more
department to handle these diseases.
affluent than it ever was, and people have access to a multitude
of dietary options. People nowadays are also less active than their
predecessors, however the calorific content of their diet hasn't
decreased; instead it has increased. Diets around the world have
drastically changed; we have transitioned from a high-protein,
high-fat diet to a high-carbohydrate, high-fat diet.
Moreover, the consumption of empty-calorie foods like alcohol,
aerated drinks, candies, cookies, chocolates etc. has also risen
sharply. All of this, coupled with a sedentary lifestyle, makes the
ideal combination for susceptibility to obesity and diabetes
Type 2 diabetes also called non-insulin-dependent diabetes
mellitus (NIDDM) has the strongest association with obesity. In
type II diabetes, the body does not respond correctly to available
insulin. In other words, a person becomes insulin resistant.
The basic principles in treating Obesity
Insulin resistance means that fat, liver, and muscle cells do not
respond normally to insulin. As a result, blood sugar does not get
Degenerative diseases of weight-bearing joints such as the
into cells to be stored for energy and the blood sugar levels
knee are common complications of obesity. The cause of this is
Ÿ Diet and healthy Eating: Healthy eating and
inevitably increase. People who are overweight are more likely to
mechanical damage to joints due to the excess weight. Lower
eating low calories with increased physical activity
have insulin resistance, because fat interferes with the body's
back pain is also more common in obese people and may be
and life style habits is the easy way to reduce weight. A
ability to use insulin. Family history and genetics play a major one of the major contributors to obesity-related absenteeism
registered dietitian will help to design a diet suitable for the
role in type II diabetes. Low activity level, poor diet, and excess
individual needs along with physical activity plan.
body weight (especially around the waist) significantly increase
Psychological Aspects
Ÿ Medications: Weight-loss medicines of various kinds are
your risk for type 2 diabetes.
available in the market, but at
Obese people are stigmatized world over. It is perceived as an
Cardiovascular Disease and Hypertension
undesirable physical appearance, and supposedly embodies
Cardiovascular disease (CVD) includes coronary heart disease
several character defects. Even children often perceive obese
(CHD), stroke and peripheral vascular disease. These diseases
children in a negative manner. It is not uncommon to see patients
have patients as our priority. And
recommend them as most of these preparations have more
account for up to 33% of deaths in most industrialized countries -
breakdown even during a consultation.
especially with regard to obesity we understand that it is a
adverse side effects compared to their benefits.
a figure that's increasing rapidly in developing countries as well.
debilitating disease of the mind, body and the Quality of life(QoL)
Obese people face discrimination everywhere. A study of
Ÿ Bariatric Surgery or Weight Loss Surgery: Bariatric surgery is the
Obese individuals are more likely to have higher blood
and MUST BE ADDRESSED HOLISTICALLY to achieve long-term
overweight young women in the USA showed that they earn
next step for people who remain severely obese after trying
triglycerides (blood fats) and low-density lipoprotein (LDL) (bad
significantly less than healthy women who are not overweight or
approaches other than surgery, especially if they have a disease
cholesterol) and lower high-density lipoprotein (HDL) (good
than women with other chronic health problems.
It has to start from you and your family UNDERSTANDING &
linked to obesity. Bariatric surgery restricts food intake, which
cholesterol). This is most often seen in obese people with high
MOTIVATION and accepting that Obesity is not just a cosmetic
leads to weight loss. Patients who have bariatric surgery must
levels of abdominal fat, and has been consistently linked to a
issue, but, its a disease that must be handled at it's roots.
Sleep apnea is a chronic condition that disrupts sleep. In this
commit to a lifetime of healthy eating and regular exercise. These
higher risk of CHD. A 10 kg weight loss can produce a 15%
condition there are one or more pauses in breathing or shallow
healthy habits may help patients maintain weight loss after
Obesity is often a misunderstood word. If one has to be cured of
decrease in LDL cholesterol levels and an 8% increase in HDL
breaths while sleeping. These breathing pauses can last from
obesity one must begin with classifying him/herself. People
a few seconds to minutes. They often occur 5 to 30 times or
whose BMI is between 23.5 - 27.5 are classified as overweight, if
more per hour. Typically, normal breathing then starts again,
not tackled in time, overweight people can easily become obese.
sometimes with a loud snore or a choking sound. Even Snoring
For these patients, we recommend our personalised Gem Weight
is a sign of Sleep apnea at it early stages.
Loss Program.
This results in poor sleep quality that makes one feel tired during
If your BMI is between 27.5 - 32.5 you fit into Grade I Obesity
the day. Sleep apnea is one of the leading causes of excessive
category. It is important to be very careful with your weight; at this
daytime sleepiness.
stage there is tremendous scope to get back to your ideal weight
yet there are equal chances to slip into Grade II Obesity.
About 3065% of hypertension (high blood pressure) sufferers in
Obesity is a leading cause of sleep apnea. It is more prevalent in
the West develop hypertension as a result of obesity. Blood
older people and is more commonly seen in males.
Grade II Obesity is often symptomatic; most patients would have
pressure increases with BMI; for every 10 kg increase in weight,
had developed co-morbidities at this stage. Type 2 Diabetes,
Diagnosis is based on history and sleep study. Weight loss leads
blood pressure rises by 2-3mm Hg. Conversely, for each 1%
hypertension, sleep apnoea, cardiac problems, joint pains are
to marked improvement in sleep apnea. Breathing devices such
reduction in body weight, blood pressure falls by 1-2mm Hg.
some of the most common co-morbidities for these individuals. It is
as CPAP are useful and smokers need to quit smoking at the
very important that one immediately takes reversal action at this
The risk of hypertension in overweight adults is nearly three times
earliest. It has been scientifically shown that Obesity Surgery
stage as this condition could lead to morbid obesity or any other
higher than in non-overweight adults. This risk is nearly six times
induced weight loss controls sleep apnea in more than 90% of
fatal illness. If one doesn't show any symptoms of co-morbidities
higher for overweight people aged between 20 and 44.
the patients.
one can certainly reduce their weight with diets and exercise and a
great amount of will power.
Several studies have found an association between obesity and
People with BMI beyond 37.5, fall in the last and the most
the incidence of certain cancers, particularly of hormone-
dangerous category called Grade III or Morbid obesity. At this
dependent and gastrointestinal cancers. Obese women have
stage diets and exercise deliver negligible results. Most patients
been proved to be at greater risk of breast, endometrial, ovarian
would have had developed more than one co-morbidity at this
and cervical cancers. There is also evidence for higher risk of
stage, many are even rendered immobile. Corrective action at this
prostate and rectal cancer in men. Obesity also increases the risk
stage is imperative, the only clinically proven way for morbidly
of colon cancer by nearly 3 times in both men and women.
obese people to lose and maintain weight is bariatric surgery.
Ÿ What is the first step in obesity management?
50 percent or more of his or her excess weight. Most patients
Ÿ Will I be able to eat all
lose all of their excess weight and gain numerous health
Dietary modification (not dietary restriction) and adequate
benefits, while some may require exercising to accelerate the
physical activity is the initial step in the management.
Yes. One can eat all kinds
weight loss rate.
of food, however it is
Ÿ Are there any medicines for weight loss?
important to make a
Ÿ Are there activity restrictions following a bariatric surgery
There are a few in the market and most of these are not
healthy choice as portion
we believe in making you understand
approved and better not recommended
sizes will be smaller.
the importance behind a healthy
Like in any other surgery a few hours or days of rest is
Ÿ Who should consider bariatric surgery?
recommended. One can resume everyday activities almost
Ÿ Can I consume alcohol?
balanced diet regimen and life style
Patients unsuccessful with conservative line of management
immediately after the surgery. We recommend a week's rest
management including adequate
Yes, alcohol is permitted 12 months after
and those who cannot try these for practical reasons, may
before resuming work. We also mention that one should avoid
surgery; however a responsible diet will not include alcohol, as
physical activity which are the corner stones of
consider this option.
strenuous activities like weight lifting etc until a month.
it has empty calories that do not deliver any nutritional value.
enduring weight loss and holistic health.
Walking is strongly recommended, to hasten the healing
Ÿ What is bariatric surgery?
Each diet is tailored keeping your lifestyle in mind, and
process and accelerate the weight loss.
Ÿ Will I have loose skin after losing my excess body weight?
Bariatric surgery is a simple surgical procedure targeted at a
Patients losing large amounts of weight may have excess skin.
is customized according to your weight/height, co-
change in physiology helping you to lose weight.
Ÿ Do insurance companies cover bariatric surgery
This depends on an individual basis, age and elasticity of one's
morbidities, metabolism and body composition.
Ÿ What are the benefits of surgery?
skin plays an integral role in determining excess skin. This to
We understand that each individual is unique and has
Unfortunately insurance companies in India do not cover
Bariatric surgery leads to drastic weight loss, in a significantly
some extent can be handled my means of toning exercises,
their own set of lifestyle constraints, nutritional needs
bariatric surgery, however efforts are being made to amend
smaller time frame; it also requires less effort to lose weight.
which we will be recommending books after surgery. If the
this, as bariatric surgery is now proving to be a lifesaver for
and activity levels. Our qualified nutritionists
More importantly bariatric surgery significantly increases the
excess skin causes skin infections or affects your appearance,
most patients.
collaborate with you to get you in touch with your
life span of an obese individual simultaneously ridding of co-
you may consider undergoing body lifts or abdominoplasty.
body and customize a basic, easy to follow and holistic
Ÿ Are there any dietary restrictions following bariatric surgery?
Ÿ Is there any problems with relation to future sexual activity or
diet and exercise plan to help you get safely and
Since bariatric surgery deals with the metabolism of the body it
Ÿ What are the various bariatric surgery procedures?
effectively to your target weight. Doing so will allow
is important to alter ones diet before and after surgery. All the
Ÿ Bioenteric Intragastric Balloon (BIB)
Definitely not. As the surgery has nothing to do with the sexual
your body to adjust slowly, making for lasting changes
dietary requirements will be taken care of by our bariatric
organs or the hormones there is no interrelationship to this
Ÿ Laparascopic Adjustable Gastric Banding (LAGB)
that will endure! Altering your diet will also help
nutritionist. A detailed pre and post operation diet plan will be
surgery and future pregnancy. In fact its one of the treatment
Ÿ Laparascopic Sleeve Gastrectomy (LSG)
reduce/eliminate acne and promote healthy, glowing
provided once planned for surgery.
options for infertility when its because of obesity.
Ÿ Laparoscopic Roux en Y Gastric Bypass (LGB)
Ÿ How long will it take to lose excess weight after bariatric
Ÿ Can I become pregnant immediately after surgery?
Ÿ What is the recovery time following bariatric surgery?
Our experienced nutritional counselors and life
No. You may have to wait for atleast a year before you can
All of our patients have recovered from a bariatric surgery
style therapists will work with you to:
Excess weight loss begins right after surgery and continues for
become pregnant for nutritional factors.
procedure without any complications. We encourage our
12-18 months after surgery.
Ÿ Identify your struggles with weight loss/weight gain
patients to get out of bed and start walking by the next day. The
Ÿ Will the scars be very obvious?
Ÿ Is it possible to gain the weight back after a bariatric surgery
Ÿ Understand and address emotional touch points
hospital stay varies from 3 to 4 days depending on each case
Not very much, The surgeries are done with 5-6 holes usually
that trigger binge eating
and the procedure opted for.
ranging from 5mm-12mm and are within the skin creases and
Bariatric surgery is the only clinically proven way to lose and
not very much obvious. But for those who are concerned of
Ÿ Formulate wholesome and satisfying meal plans
Ÿ When is bariatric surgery considered successful?
maintain weight. However there are marginal chances of
this, there's a newer modality called SINGLE INCISION
that balance caloric requirements with taste
Success in weight loss is inevitable with bariatric surgery.
weight gain, only if one opts for an irresponsible and unhealthy
LAPAROSCOPIC SURGERY, where the entire surgery is done
However we consider it successful only when our patient loses
through one hole within the umbilicus which is hidden.
We are here to
lost world !!!
Source: http://obesitysurgeryindia.com/download/Facts-Tips-Obesity.pdf
Neurocomputing 38}40 (2001) 93}98 A bursting mechanism of chattering neurons based on Ca>-dependent cationic currents Toshio Aoyagi *, Nobuhiko Terada, Youngnam Kang, Takeshi Kaneko, Tomoki Fukai Department of Applied Analysis and Complex Dynamical Systems,Graduate School of Informatics, Kyoto University, Kyoto 606-8501 Japan
International Journal of Systematic and Evolutionary Microbiology (2013), 63, 893–899 Pseudonocardia antitumoralis sp. nov., adeoxynyboquinone-producing actinomyceteisolated from a deep-sea sediment Xin-Peng Tian,1 Li-Juan Long,1 Su-Mei Li,1 Jing Zhang,1 Ying Xu,2Jie He,2 Jie Li,1 Fa-Zuo Wang,1 Wen-Jun Li,2 Chang-Sheng Zhang1and Si Zhang1 1Key Laboratory of Marine Bio-resources Sustainable Utilization, CAS; RNAM Center for Marine