Definition and BMI Scale

Obesity is defined as excessive fat accumulation that poses a risk to health.
It’s commonly measured using Body Mass Index (BMI) — calculated by dividing a person’s weight (kg) by the square of their height (m²).

BMI Classification

• Normal: 18.5–24.9

• Overweight: 25–29.9

• Obese (Class 1): 30–34.9

• Obese (Class 2): 35–39.9

• Morbidly Obese (Class 3): 40+

Types of Obesity

Not all obesity is the same:

• Central obesity (belly fat): The most dangerous type, linked to metabolic disorders.

• Peripheral obesity: Fat around the limbs.

• Mixed obesity: A combination of both.

Each type carries unique risks and challenges.

Causes of Obesity

1. Genetics

Some people are genetically predisposed to gain weight more easily.
But remember — genes are not destiny, they’re just one piece of the puzzle.

2. Lifestyle and Habits

High-calorie diets, sedentary lifestyle, screen addiction, and poor sleep patterns all play major roles.

3. Medical Conditions

Conditions such as hypothyroidism, PCOS, Cushing’s syndrome, and certain medications can make weight management harder.

Health Risks Linked to Obesity

Obesity doesn’t just change how you look — it deeply impacts your overall health.

• Diabetes: Obesity leads to insulin resistance, increasing the risk of type 2 diabetes.

• Heart Disease: Excess fat increases pressure on the heart, leading to hypertension, stroke, and heart attacks.

• Sleep Apnea: Fat around the neck can block airways during sleep, causing poor rest, snoring, and fatigue.

• Mental Health: Obesity can contribute to depression, anxiety, low self-esteem, and social withdrawal.

Non-Surgical Weight Loss Options

Diet and Exercise

They work — but only if done consistently and mindfully.
Focus on:

• Portion control

• Balanced macros

• Daily movement

Behavior Therapy

Cognitive Behavioral Therapy (CBT) helps identify emotional eating triggers and build healthier habits.

Medications

• Prescription Drugs: Orlistat, Semaglutide, or Phentermine can assist when paired with lifestyle changes.

• Supplements (Use Caution): Many over-the-counter pills lack evidence and can be harmful.

Intra-Gastric Balloon Placement

A minimally invasive, non-surgical option for people with a BMI between 25–35 who haven’t succeeded with lifestyle changes.

A soft silicone balloon is inserted into the stomach (with or without an endoscope) and filled with saline.
It stays for around 6 months, making you feel full faster and encouraging better eating habits.

Pros

• No surgery or anesthesia required

• Reversible and temporary

• Encourages portion control

Cons

• Temporary — weight may return if habits don’t change

• Possible nausea or discomfort early on

• Not suitable for certain stomach conditions

Think of it as training wheels for your stomach — helping you understand your body’s true food needs.

When to Consider Weight Loss Surgery

Eligibility Criteria

You may be a candidate if:

• BMI ≥ 40 (2.5–5.0 lesser for Indian population)

• BMI ≥ 35 (2.5–5.0 lesser for Indian population) with health issues like diabetes or sleep apnea

• You’ve tried and failed traditional weight-loss methods

Warning Signs

Uncontrolled weight gain, fatigue, labored breathing, or obesity-related diseases are red flags.

Psychological Evaluation

A mental health check ensures you’re emotionally prepared for the lifestyle shift post-surgery.

Types of Weight Loss Surgeries

Gastric Bypass (Roux-en-Y)

Reduces stomach size and reroutes the intestines — you eat less and absorb fewer calories.

Sleeve Gastrectomy

Removes 80% of the stomach, leaving a small sleeve-shaped pouch for earlier satiety.

Biliopancreatic Diversion with Duodenal Switch (BPD/DS)

A more complex procedure combining restriction and malabsorption — typically for those with very high BMIs.

How Weight Loss Surgery Works

• Restrictive procedures: Reduce stomach size so you feel full faster.

• Malabsorptive procedures: Limit calorie and nutrient absorption by bypassing parts of the intestine.

• Combination procedures: Do both — e.g., gastric bypass, BPD/DS.

Benefits of Weight Loss Surgery

• Rapid Weight Loss: Lose 50–70% of excess weight within 12–18 months.

• Improved Quality of Life: Everyday tasks become easier.

• Resolution of Comorbidities: Many see diabetes, hypertension, and fertility issues improve dramatically.

Risks and Side Effects

Short-Term Risks

Infection, bleeding, blood clots, and anesthesia complications.

Long-Term Complications

• Ulcers

• Gallstones

• Dumping syndrome (after gastric bypass)

• Nutritional deficiencies

Lifelong supplements of B12, iron, calcium, and vitamin D may be needed.

Preparing for Weight Loss Surgery

Diet Prep

Most surgeons recommend a high-protein, low-carb diet before surgery to shrink the liver.

Mental Prep

Prepare to manage cravings, emotional eating, and new lifestyle habits.

Insurance and Paperwork

Check your insurance coverage — most require documentation of failed weight-loss attempts.

Life After Surgery

Recovery Timeline

• Hospital stay: 1–3 days

• Return to work: 2–4 days

Diet and Eating Habits

Progression: liquids → puree → soft foods → solid foods
Focus on high protein, low sugar, small portions.

Exercise and Activity

Start with light walking, then gradually increase activity after 4–6 weeks.

Emotional and Psychological Journey

Support Groups

Joining a bariatric support group can keep you motivated and accountable.

Mental Health Support

Therapy helps handle body image changes and the emotional side of weight loss.

Dealing with Body Image Issues

Loose skin or scars can feel overwhelming — remember, self-love takes time.

Weight Regain After Surgery

Why It Happens

Old habits, snacking, or stretching the stomach pouch can lead to weight gain.

How to Prevent It

Follow your nutritionist’s plan, attend follow-ups, and stay active.

If It Happens

Don’t panic — reach out to your bariatric team.
Revision procedures or counseling can help.

Success Stories

Real-Life Transformations

From struggling to walk to running marathons, many patients regain control of their health.

Inspirational Takeaway

Surgery isn’t cheating — it’s a tool, and success depends on how you use it.

The Future of Obesity Treatment

• Emerging Technologies: Endoscopic sleeve gastroplasty, intragastric balloons, robotic surgeries

• Minimally Invasive Procedures: Faster recovery and fewer scars

• Personalized Medicine: Gene-based diets and AI-driven treatment plans are on the horizon

Conclusion

Obesity is a complex, chronic condition that impacts every part of life.
But with the right tools, mindset, and medical support, recovery is possible.

Weight loss surgery isn’t magic — it’s empowerment.
A step toward a healthier, more confident version of you.

FAQs

1. What’s the safest type of weight loss surgery?

Gastric sleeve is generally considered safest, but suitability depends on your health condition.

2. Can obesity return after surgery?

Yes, if old habits return. Surgery is a tool — consistency is the cure.

3. How soon can you exercise after surgery?

Light walking starts immediately; more intense workouts after 4–6 weeks.

4. Do you have to diet after surgery?

Absolutely — lifelong healthy eating is essential.

5. Is weight loss surgery reversible?

Most types are technically reversible, but reversals are rare and only done for medical reasons.