Rising obesity & emerging challenges associated with it
Considering the available statistics, obesity has been emerging as a global epidemic. As per WHO statistics, published in 2016, more than 1.9 billion adults, 18 years and above were overweight. Of these, over 650 million were obese [1]. The prevalence of overweight and obesity in India is increasing faster than the world average [2].
“Of course, obesity is a complex health issue, emerging as a global epidemic and the second most common preventable cause of death posing multiple challenges, but feasible solutions are also there. Behind obesity, there are a combination of causes and individual factors such as behavior and genetics. Behaviors can include physical activity, inactivity, dietary patterns, medication use, and other exposures. Additional contributing factors include the food and physical activity environment, education and skills, and food marketing and promotion. Also, obesity is not a single disease, but it brings along 225 other diseases, which are directly or indirectly associated with it,” says Dr Ramen Goel, Director, Bariatric Surgery, Wockhardt Hospital, Mumbai.
Talking about the seriousness of the disease, and its repercussions Dr Goel said, “Obesity and associated issues are likely to result in a situation when for the first time in the history of mankind, the next generation might live shorter than their parents. However, to curb the increasing incidence of obesity and associated diseases, there are certain treatment options with their limitations. The natural treatment options are calorie restriction diet and exercise. And if these measures fail, there is an option for weight loss surgery. However, in a calorie restriction diet, there is probability of re-gaining over 50% of lost weight, after a year or two. Moreover, regular exercise helps to some extent in controlling obesity. In surgical options, Bariatric surgery is the most prevalent.”
Bariatric surgery is an effective treatment for severe obesity that results in the improvement or remission of many obesity-related comorbid conditions, as well as sustained weight loss and improvement in quality of life. The sleeve gastrectomy and gastric bypass surgery are the two important methods involved in Bariatric surgery. With mortality comparable to common elective general surgical operations, Bariatric surgery is now safe. [3]
Contemporary bariatric surgery is now safe; however, all bariatric operations are associated with their own unique short-term and long-term nutritional and procedural-related complications. Type 2 diabetes mellitus (T2DM) is the most studied metabolic disorder associated with obesity, with data demonstrating that improvement and remission of T2DM in patients with obesity is superior after bariatric surgery compared with conventional medical therapy. Bariatric surgery is now a part of some treatment algorithms for the medical management of patients with Type-2 Diabetes and severe obesity. [3]
“It has been observed that post bariatric surgery, cardio-vascular risk has been reduced by 30%; significant reduction in breast and endometrial cancers is seen; reversal of NAFLD (Fatty liver), NASH and even Fibrosis in 65%. Hormonal normalization and improved fertility in PCOD in almost 100% women and discontinuation of CPAP is more than 93%. Although lifelong healthy eating and exercises remains the mainstay of obesity treatment, yet these have limited long term outcomes. Bariatric surgery remains as a treatment offering significant and sustained weight loss – also an insurance approved obesity treatment modality,” added Dr Goel.
References:
[1] https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
[2] Luhar S, Timæus IM, Jones R, et al. Forecasting the prevalence of overweight and obesity in India to 2040. PLoS One. 2020;15(2):e0229438. Published 2020 Feb 24. doi:10.1371/journal.pone.0229438
[3] Nguyen, N., Varela, J. Bariatric surgery for obesity and metabolic disorders: state of the art. Nat Rev Gastroenterol Hepatol 14, 160–169 (2017). https://doi.org/10.1038/nrgastro.2016.170