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Obesity

Introduction

Obesity is a very common problem in Australia and the western world, affecting 2 thirds of adults and an increasing percentage of children and adolescents. It is defined by having a body mass index (BMI = weight(kg) divided by height(m)2) over 25 kg/m2.

Causes

There are many causes of obesity, but by far the biggest is dietary changes over the last 60 years, prior to which obesity was very rare. This is best described as a diet high in mass-produced foodstuffs that are full of refined carbohydrate (sugar and starch). These foods cause high insulin levels, which then cause weight gain and constant hunger.

Other relevant causes include:

  • inadequate fibre intake.
  • poor sleep habits.
  • inadequate activity levels.
  • inadequate outdoors time (sunlight and fresh air).
  • constant eating/snacking rather than 2 - 3 meals per day.
  • busy lifestyles.

Symptoms

Symptoms of being overweight include:

  • decreased quality of life.
  • shortness of breath.
  • reflux/heartburn.
  • sore joints (especially back, hips, knees, ankles).
  • fatigue.
  • difficulties with the activities of daily living and work.
  • sexual dysfunction.
  • headaches.

Diseases associated with being overweight, often greatly improved or cured by Weight Loss Surgery:

  • Hypertension (high blood pressure).
  • High cholesterol.
  • Fatty liver disease (NAFLD).
  • Type II Diabetes.
  • Obstructive Sleep Apnoea (OSA).
  • Reflux and Hiatus Hernia (GORD).
  • Weight Related Joint Disease.
  • Benign Intracranial Hypertension (headaches).
  • Infertility.
  • Hernias.

Tests

No specific tests are required to diagnose obesity. A Weight Loss Surgery consultation with Dr Ben Dodd involves a detailed weight history and analysis of your weight related medical problems. If you proceed to Weight Loss Surgery, further assessment of your breathing (sleep studies, looking for Obstructive Sleep Apnoea) and heart function (echocardiogram, or heart ultrasound) may be necessary.

Diagnosis

Diagnosis of being overweight is by calculating your BMI (see link below). The decision by Dr Ben Dodd to recommend surgery is based on your BMI and your weight related comorbidites (medical problems), along with your fitness for general anaesthesia.

Treatment

According to consensus world guidelines, Weight Loss Surgery is indicated when the following conditions are met:

  • BMI > 40, or >35 with weight related comorbidites.
  • BMI > 30-35 with type 2 diabetes or increased cardiovascular risk (lower for people of Asian background).
  • Unsuccessful attempts at weight loss through diet and exercise.
  • No major psychiatric illness or substance abuse disorders.
  • Adequate cardiorespiratory (heart and lung) fitness for surgery.

Related Information

BMI calculator
Weight Loss Surgery