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Obesity Surgery in Pune

What is obesity:

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems.

Why obesity happens:

Here is the simple explanation, your body needs energy to function and your energy source is the food that you eat. A normal weight person successfully balances their energy intake (food eaten) with their energy requirements (daily activity). In other words, they burn up all the energy provided by the food they eat, and stay slim. However, you began to get fatter when you started to eat more food than you needed for your energy requirements. Over a long period of time the excess has been stored as fat around your body. In theory, just 100 calories eaten more than you need each day would lead to a weight gain of 5 kgs per year. Do that for 10 years and you could gain over 45kgs! Obesity is most commonly caused by a combination of excessive food energy intake, lack of physical activity, and genetic susceptibility, although a few cases are caused primarily by genes, endocrine disorders, medications or psychiatric illness. Eating too many calories for our energy needs is a major candidate for the main cause of the modern obesity epidemic. Overconsumption of trans-fats and refined white flour carbohydrates, combined with low fiber intake also plays an important role in the rise of obesity.

Obesity is defined by body mass index (BMI) and further evaluated in terms of fat distribution via the waist–hip ratio and total cardiovascular risk factors. BMI is closely related to both percentage body fat and total body fat.

Complications of Obesity :

Some people can be very overweight and not suffer any major medical problems – you may be one of them. However, the truth is that being overweight dramatically increases your chances of suffering a serious health problem in the near future (sometimes referred to as an obesity–related disease). Here are some scary statistics for you:

If you are obese you are:

  • 6 times more likely to develop gallbladder disease
  • 5.6 times more likely to develop high blood pressure
  • 3.8 times more likely to develop diabetes
  • twice as likely to develop arthritis
  • more likely to develop some cancers including prostate, breast, cervix and ovarian cancer
  • more likely to have a stroke
  • more likely to suffer back problems
  • more likely to be infertile
  • more likely to suffer depression
  • more likely to snore and suffer sleep disorders

And probably most importantly of all, your life expectancy is much shorter than that of a normal weight person .On average, obesity reduces life expectancy by six to seven years: a BMI of 30–35 reduces life expectancy by 2 to 4 years, while severe obesity (BMI > 40) reduces life expectancy by 10 years.

How overweight are you?

To measure this, experts now talk about your BMI, or body mass index. This is calculated by dividing your weight in kg by your height in metres, twice. Here are some basic definitions for you:

BMI less than 18 kg/m² Underweight

BMI 18 - 25 kg.m²Normal

BMI 25 - 30 kg/m² Overweight

BMI 30 - 35 kg/m² Obese

BMI 35 - 40 kg/m² Severely obese

BMI over 40 kg/m² Morbidly obese

BMI over 50kg/m² Super obese

BMI over 60kg/m² Super–super obese

This classification is for western population, for indians, the BMI cut-offs have been reduced by 2.5 kg/mt2 .

How do I deal with obesity?

The aim of treatment for obesity is to lose weight in order to improve your general quality of life, both physically and psychologically. For example, losing weight may help you sleep better, or help you to improve your self-esteem. The best way to treat obesity is to reduce the amount of calories in your diet and to exercise more. The type of diet and exercise that will benefit you, and that you can follow safely, will vary from person to person.

At jehangir- apollo hospital, Pune there is a dedicated obesity surgery unit, with leading super specialist trained from world renowned institutions. Doctors at Jehangir Hospital brings with them vast experience in dealing morbidly obese patients. The obesity unit has a dedicated surgical team, specialist dietician, anaesthetist, diabetologist, physiotherapist and psychological assessment team. There are various ways you can deal with morbid obesity:

-Diet:

In order to lose weight, you need to eat a healthy diet and reduce the amount of calories in your diet. This will mean changing your eating habits.

A healthy diet should contain:

  • meals based on starchy, high-fibre carbohydrates, such as wholegrain bread, chapati, pasta and rice
  • at least five portions of fruit and vegetables every day
  • a moderate amount of low-fat protein, milk and dairy products
  • a very small amount of foods that are high in fat, sugar or salt

A calorie-controlled or low-fat diet should only be attempted with expert support and advice. Similarly dieting in adolescents and pregnant women should be done under expert supervision.

-Increase your exercise

Research suggests that increasing the amount of exercise you do is an effective way to lose weight, and the results are even better when combined with changes to your diet.

Recommended types of physical exercise include:

  • activities that can be incorporate into everyday life, such as brisk walking, gardening, or cycling,
  • supervised exercise programs, and activities such as swimming, walking (where you aim to walk a certain number of steps a day), and stair climbing.

Chose physical activities that you enjoy, as you are more likely to continue doing them. The advice from experts about exercise will vary depending on how fit you are to start with, and what it is safe for you to do.

-Medication

Medication for obesity is considered for selected patients by our weight loss team. You need to show you can lose weight on a calorie controlled diet before it is considered. Medication is normally one part of a weight loss programme, and requires a long-term change in lifestyle for lasting results.

Orlistat: Orlisat works by blocking the action of an enzyme (a protein that speeds-up and controls chemical reactions in the body) that is used to digest fat. The undigested fat is not absorbed into your body, and is passed out with your faeces (stools). As you are absorbing less fat, you should lose weight. Treatment with orlistat, which initially is for 3 months, must be combined with a low fat diet and other weight loss strategies, such as doing more exercise. This treatment has side-effects such as oily stools. Treatment can have serious complications and should be undertaken under medical supervision who have adequate experience and as a part of weight reduction programme.

Intragastric balloon for obesity

With the failure of conventional treatments like diet therapy, increased physical activity and drug therapy in producing long lasting weight loss in people with obesity, other approaches like surgery are performed in specialised centres, an option to be considered for patients with morbid obesity who do not respond to clinical treatment. The silicon intragastric balloon (IGB) has been developed as a temporary aid to especially achieve weight loss in obese people with 40% or more their optimal weight, who have had unsatisfactory results in their treatment for obesity, despite of being cared for by a multidisciplinary team and in super obese patients who often have a high risk for surgery. The concept is simple. A deflated soft silicone gastric balloon is inserted into the stomach via the mouth and filled with liquid or air, reducing the amount of food the stomach can hold and causing leads to a premature feeling of satiety

The balloon can be left in place for up to six months.

Surgery for obesity:

We have now enough evidence to suggest that surgery for morbid obesity offers an effective and sustained weight loss as compared to other modalities such as lifestyle modification and medications.

What is obesity surgery: Bariatric (obesity) surgery, also known as weight loss surgery, refers to the operations designed to reduce weight (bariatric come from the Greek meaning pressure or weight). Operations may restrict the amount you are able to eat (restrictive operations such as the gastric band or sleeve gastrectomy) or both restrict the amount you can eat and reduce the amount you can absorb (gastric bypass ). The term does not include procedures for surgical removal of body fat such as liposuction.

How surgery works: The human body lays down fat stores if the calories in the food you eat exceed the energy you burn up. There are a number of complex processes which the medical profession are only just starting to understand that seem to contribute to increasing obesity - the appetite mechanisms go wrong and you continue to eat even though you do not need the calories. And of course, once your body is carrying the extra weight, it becomes harder to be physically active which would help to regulate your weight. Obesity surgery works by helping to reduce the number of calories that are available in your body.

There are two ways this can be achieved surgically:

  • Restriction - by reducing the size of the stomach, only small meals can be eaten and the appetite is satisfied
  • Malabsorption - by bypassing part of the small intestine, less calories from food are absorbed by the body

The operations that work by restriction are:

  • Gastric band
  • Sleeve gastrectomy

The operations that work by a combination of restriction and malabsorption are:

  • Roux and Y gastric bypass

Obesity surgical unit at Jehangir- Apollo hospital, Pune, which is lead by Dr Girish Bapat is able to offer all types of bariatric surgery as key hole (laparoscopic) procedures which has less post surgery pain, complications, early discharge, faster recovery and better cosmetic results.

Life after weight loss surgery:

Weight loss of 65 to 80% of excess body weight (the amount by which actual body weight exceeds actuarial ideal body weight) is typical of most large series of Gastric Bypass operations reported. The medically more significant effects are a dramatic reduction in co-morbid conditions:

  • Hyperlipidemia (high cholesterol) is corrected in over 70% of patients.
  • Essential hypertension (high BP) is relieved in over 70% of patients, and medication requirements are usually reduced in the remainder.
  • Obstructive sleep apnea is markedly improved with weight loss and bariatric surgery may be curative for sleep apnea. Snoring also improves in most patients.
  • Diabetes mellitus type 2 is reversed in up to 60- 80% of patients usually leading to a normal blood sugar without medication, sometimes within days of surgery.
  • Gastroesophageal reflux disease is relieved from the time of surgery in almost all patients.
  • Venous thromboembolic disease signs such as leg swelling are typically much improved.
  • Low back pain and joint pain are typically relieved or improved in nearly all patients.

Weight loss surgery can achieve often impressive results in the amount of weight lost, but it should not be seen as a magic cure for obesity. Both the sleeve gastrectomy and bypass restrict how much food you can take at one time helping you to limit food intake, thus lose weight. This plan will include:

  • a carefully controlled diet , including vitamin and calcium supplementation
  • regular exercise

At Jehangir obesity surgery unit, our specialist dietician will advise you before and after surgery to settle into your new life style. After surgery patients are seen at our clinic at regular basis to ensure that they settle well into their new life style. We make sure that while undergoing surgical treatment and recovery, you are not alone, help is always at hand and always call us for any help or advice.

Dr Girish Bapat
MBBS, MS (Gen. Surgery), FRCS (Glasgow), FRCS (Intercollegiate),
Consultant Obesity Surgeon at Jehangir- Apollo Hospital, Pune

Dr Girish Bapat working as a bariatric (obesity) surgeon at Jehangir Hospital. Dr Bapat has been working in England for last 15 years brings with him vast experience in leading weight loss programme and performing morbid obesity operations. Dr Bapat has presented his research articles in various international meetings. He highlights the danger of ever increasing problem of obesity and related illnesses such as diabetes, high BP, cholesterol, infertility, early onset of arthritis etc. He recommends various treatment options including surgery to deal with this problem.

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Do make an appointment for your Health Check and if it's your first time at Jehangir Hospital, you will need to register yourself at Jehangir hospital by paying nominal registration fee

Jehangir Silver

  • Hemogram (HB, PVD, TLC, RBC Count, MCV, MCH, MCHC, Platelet Count, Automated DLC, Absolute Dif ferential Count, RDW)
  • Blood Group and RH Typing
  • Urine (Routine)
  • Stool (Routine)
  • Sugar (Fasting & Postprandial)
  • Blood Urea
  • Serum Creatinine
  • Uric Acid
  • SGPT
  • X-Ray Chest
  • ECG
  • Lipid Profile (Total Cholesterol, Triglycerides, HDL-Direct, LDL-Direct, VLDL-Calculated)
  • 2D Echo
  • Stress Test
  • Ultrasound (Whole Abdomen & Pelvis)
  • Dental Check Up
  • Physician Consultation & Physical Examination

12-14 HRS.FASTING REQUIRED

*Breakfast Included

Rs-3500

Book your Package Wellness Instruction

Important Health Check Instructions

  • Do make an appointment for your Health Check and if it's your first time at Jehangir Hospital, you will need to register yourself. You can use this registration number every time after that. Reporting Time: 8 am to 9:30 am.
  • You need to fast for 12 hours before your Health Check- no eating or drinking anything except plain water. Do not take any medicines, do not smoke, do not drink alcohol for 12 hours before the check up. Beta blockers should be stopped 48 hours before your check up. Do not wear contact lenses for 24 hours before the check up-you can carry your reading glasses with you.
  • In case you are diabetic, you should carry your medicines with you and you can take them after breakfast.
  • Bring all your medicinal records with you.
  • Wear loose clothing, preferably a two-piece and footwear that you can remove easily. Do not wear any jewellery.
  • Men should shave their chest hair for better results in the ECG and Stress tests.
  • You will need to inform the Health Check desk in advance if you want any additional investigations/procedures/consultations. We will try and fit in appointments for you. All additional tests will be charged extra.
  • You can come in for your reports and discussions after 2 days. You will need to make an appointment at the Health Check desk for consultations.

Caution for Women

  • No X-Rays to be done if you are pregnant or suspect that you are pregnant.
  • Do not make an appointment for a Health Check during menstrual periods.

For any queries, please contact the Health Check desk.
Please do consult your doctor before stopping your medication.

Jehangir Gold

  • Hemogram (HB, PVD, TLC, RBC Count, MCV, MCH, MCHC, Platelet Count, Automated DLC, Absolute Dif ferential Count, RDW)
  • LFT (SGPT, SGOT, Bilirubin, Total, Direct & Indirect, Alkaline Phosphatase, Protein Total, Albumin, Globulin, A:G Ratio)
  • Blood Group and RH Typing
  • Urine (Routine)
  • Stool (Routine)
  • X-Ray Chest
  • ECG
  • Sugar (Fasting & Postprandial)
  • Lipid Profile(Total Cholesterol),
  • Triglycerides, HDL-Direct, LDL-Direct, VLDL-Calculated)
  • HbA1C
  • Blood Urea
  • Serum Creatinine
  • Uric Acid
  • Stress Test
  • Pulmonary Function Test
  • Bone Densitometry (Dexa-Spine)
  • Ultrasound (Whole Abdomen & Pelvis)
  • Eye Check Up & Consultation
  • Dental Check Up
  • Physician Consultation

12-14 HRS.FASTING REQUIRED

*Break Fast Included

Rs-5000

Book your Package Wellness Instruction

Jehangir Platinum (Whole Body Screening)

  • Hemogram (HB, PCV, TLC, RBC Count, MCV, MCH, MCHC, Platelet Count, Automated DLC, Absolute Dif ferential Count, RDW)
  • Blood Group and RH Typing
  • Urine (Routine)
  • Stool (Routine)
  • Sugar (Fasting & Postprandial)
  • X-Ray Chest
  • ECG
  • Lipid Profile (Total Cholesterol, Triglycerides, HDL-Direct, LDL-Direct, VLDL-Calculated)
  • HbA1C
  • Blood Urea
  • Serum Creatinine
  • Uric Acid
  • LFT (SGPT, SGOT, Bilirubin, Total, Direct & Indirect, Alkaline Phosphatase, Protein Total, Albumin, Globulin, A:G Ratio)
  • T3+T4+TSH
  • Vitamin B12
  • Vitamin D3
  • Ultrasound (Whole Abdomen & Pelvis)
  • Stress Test
  • 2D Echo
  • Pulmonary Function Test
  • Bone Densitometry (Dexa-Spine)
  • Carotid Doppler
  • Audiometry
  • Mammography (Women)
  • PAP Smear (Women)
  • PSA (Men)
  • Physician Consultation & Physical Examination
  • Gynecological Consultation
  • Eye Check Up & Consultation
  • Dental Check Up
  • Cardiac Consultation
  • Dietary Consultation
  • Homeopathic Consultation

12-14 HRS.FASTING REQUIRED

* Breakfast included

Rs-10000

Book your Package Wellness Instruction

Jehangir Comprehensive Obesity Screening

  • Hemogram (HB, PCV, TLC, RBC Count, MCV, MCH, MCHC, Platelet Count, Automated DLC, Absolute Dif ferential Count, RDW)
  • LFT (SGPT, SGOT, Bilirubin, Total, Direct & Indirect, Alkaline Phosphatase, Protein Total, Albumin, Globulin, A:G Ratio)
  • HbA1C (Glycosylated Hemoglobin)
  • T3+T4+TSH
  • Blood Urea
  • Ultrasound (Whole Abdomen & Pelvis)
  • Lipid Profile (Total Cholesterol, Triglycerides, HDL-Direct, LDL-Direct, VLDL-Calculated)
  • Serum Creatinine
  • ECG
  • Body Fat Analysis, Height, Weight
  • BMI
  • Physician Consultation & Physical Examination
  • Dietician Consultation
  • Obesity (Bariatric) Surgeon Consultation

*Break Fast Included

12-14 HRS.FASTING REQUIRED

Rs-3000

Book your Package Wellness Instruction

Jehangir Hypertension & Diabetes Screening

  • Hemogram (HB, PCV, TLC, RBC Count, MCV, MCH, MCHC, Platelet Count, Automated DLC, Absolute Dif ferential Count, RDW)
  • Urine (Routine)
  • ECG
  • X- Ray Chest
  • SGPT
  • Blood Urea
  • Lipid Profile (Total Cholesterol, Triglycerides, HDL-Direct, LDL-Direct, VLDL-Calculated)
  • Sugar (Fasting & Postprandial)
  • HbA1C (Glycosylated Hemoglobin)
  • Eye Check Up & Consultatio
  • Physician Consultation & Physical Examination

*Break Fast Included

12-14 HRS.FASTING REQUIRED

Rs-2800

Book your Package Wellness Instruction

Jehangir Special Heart

  • Hemogram (HB, PCV, TLC, RBC Count, MCV, MCH, MCHC, Platelet Count, Automated DLC, Absolute Differential Count, RDW)
  • Lipid Profile (Total Cholesterol, Triglycerides, HDL-Direct, LDL-Direct, VLDL-Calculated)
  • ECG
  • X-Ray Chest
  • 2D Echo Test
  • Stress Test
  • Cardiac Consultation
  • Sugar (Fasting & Postprandial)
  • Blood Urea
  • SGPT
  • Serum Creatinine
  • Ultrasound (Whole Abdomen & Pelvis)
  • Physician Consultation & Physical Examination

*BreakFast Included

12-14 Hrs. Fasting Required

Rs-3500

Book your Package Wellness Instruction

Jehangir Advanced Heart Check-up

  • Hemogram (HB, PCV, TLC, RBC Count, MCV, MCH, MCHC, Platelet Count, Automated DLC, Absolute Dif ferential Count, RDW)
  • Sugar (Fasting & Postprandial)
  • Renal Profile (Uric Acid, Serum Calcium, Phosphorus, Electrolytes (NA & K), AGPT, Serum Alkaline Phosphatase, Total Protein, Albumin)
  • Uric Acid
  • X-Ray Chest
  • 2D Echo
  • Lipid Profile (Total Cholesterol, Triglycerides, HDL-Direct, LDL-Direct, VLDL-Calculated)
  • Stress Test
  • Urine (Routine)
  • Ultrasound (Whole Abdomen & Pelvis)
  • ECG
  • Homocysteine levels
  • CT Angiography
  • Apolipoprotein A 1 B
  • Lipoprotein (A)
  • Physician Consultation & Physical Examination
  • Cardiac Consultation

12-14 HRS.FASTING REQUIRED

*Break Fast Included

Rs-13000

Book your Package Wellness Instruction

Jehangir Well Women-Gold

  • Hemogram (HB, PCV, TLC, RBC Count, MCV, MCH, MCHC, Platelet Count, Automated DLC, Absolute Dif ferential Count, RDW)
  • T3+T4+TSH
  • Sugar (Fasting & Postprandial)
  • Lipid Profile (Total Cholesterol, Triglycerides, HDL-Direct, LDL-Direct, VLDL-Calculated)
  • Bone Densitometry (Dexa-Spine)
  • ECG
  • X-Ray Chest
  • Stool Examination
  • Ultrasound (Abdomen & Pelvis)
  • PAP Smear
  • Mammography or Sono-Mammography
  • Gynecological Check Up
  • Serum Creatinine
  • SGPT
  • Urine (Routine)
  • Physician Consultation & Physical Examination

12-14 HRS. FASTING REQUIRED

* Breakfast included

Rs-4000

Book your Package Wellness Instruction

Jehangir Well Women-Platinum

  • Hemogram (HB, PCV, TLC, RBC Count, MCV, MCH, MCHC, Platelet Count, Automated DLC, Absolute Differential Count, RDW)
  • Sugar (Fasting & Postprandial)
  • Urine (Routine)
  • Blood Urea
  • Creatinine
  • SGPT
  • ECG
  • X-Ray Chest
  • Ultrasound (Abdomen & Pelvis)
  • Mammography or Sono-Mammography
  • PAP Smear
  • Lipid Profile (Total Cholesterol, Triglycerides, HDL-Direct, LDL-Direct, VLDL-Calculated)
  • T3+T4+TSH
  • Bone Densitometry (Dexa-Spine & Hip)
  • Vitamin B12 & Folic Acid
  • Vitamin D3 Level
  • Orthopedic Consultation
  • Physician Consultation & Physical Examination
  • Gynecological Check Up & Consultation
  • Dietician Consultation
  • Homeopathic Consultation

12-14 HRS.FASTING REQUIRED

*Break Fast Included

Rs-7000

Book your Package Wellness Instruction

Jehangir Spine Health (Back & Neck Pain) Screening

  • Hemogram with ESR (HB, PCV, TLC, RBC Count, MCV, MCH, MCHC, Platelet Count, Automated DLC, Absolute Differential Count, RDW)
  • Serum Calcium
  • Uric Acid
  • C-Reactive Protein (CRP)
  • Vitamin B12
  • Urine Examination (Routine)
  • Spine X-Ray Cervical (Neck)
  • Thoracic (Mid Back) or Lumbar (Lower Back) (Clear Bowel & Preparation Required)
  • Physician Consultation & Physical Examination
  • Spine Surgeon Consultation..

12-14 HRS.FASTING REQUIRED

Rs-3500

Book your Package Wellness Instruction

Jehangir Joint and Bone Health

  • Hemogram (HB, PCV, TLC, RBC Count, MCV, MCH, MCHC, Platelet Count, Automated DLC Absolute Dif ferential Count, RDW)
  • Serum Calcium
  • Uric Acid
  • C-Reactive Protein (CRP)
  • Rheumatoid Factor
  • Blood Urea
  • Serum Creatinine
  • Serum Electrolyte (NA+ & K+) (Sodium & Potassium)
  • Urine Examination
  • Serum Phosphorus
  • Vitamin B12
  • Serum Alkaline Phosphatase
  • Bone Densitometry (Spine & Hip)
  • X-Ray - Hip Joint (2 Films) or Knee
  • (2 Films) or Shoulder (2 Films)
  • Physician Consultation & Physical Examination
  • Orthopedic Consultation

Rs-4000

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