Coping with obesity

Suffering from obesity? Obesity can be improved by changing diet and daily living habits, exercising, medication and surgical treatment.

Diet, exercise and living habits

For people with severe obesity, the effect of adjusting daily living habits is very limited: large study samples indicated that only 5-10 percent of patients can keep ideal weight a few years later. Jiahui dietitian and physical therapists are dedicated to offer individualized living habits adjustment plans to help our clients reducing weight effectively. With the guidance and supervising of our professionals, better weight loss goal will be achieved.

Medication treatment
Medications can be treated as one of alternative methods for obesity and overweight clients, but diet and living habit adjustment cannot be replaced. Comparing to living habit adjustment only, taking medications plus living habit change usually can reduce extra 3-9 percent weight for clients. However, medication treatment is not for everyone: children, elderly people over 70 (especially elder adults with multiple illnesses) and pregnant women are not for medication treatment. Moreover, medications have side effects, and weight might regain after terminating medications also needs to be noticed when selecting this treatment option.

Surgical treatment plan for obesity, Type 2 Diabetes and metabolic syndromes

1.Laparoscopic Sleeve Gastrectomy

Sleeve gastrectomy is the most common surgical weight loss option worldwide. The surgery is relatively simple, safe, and the chances of developing long-term complications is low. This surgery limits the volume of the stomach in order to achieve weight loss, removing 60-70% of the greater curvature of the stomach, and reducing the patient's food intake. Sleeve gastrectomy also removes the fundus of the stomach that secretes appetite-stimulating hormones, which makes the patient less hungry and reduces cravings for food.

2.Laparoscopic Roux-EN-Y gastric bypass

Roux-en-Y gastric bypass surgery not only limits the patient's food intake, but also reduces the effectiveness of nutrients absorption in the stomach and intestines. This surgery reduces the size of your upper stomach to a small 60-100ml pouch. The surgeon does this by stapling off the upper section of the stomach, reducing the amount of food you can eat. The surgeon then attaches this pouch directly to part of the small intestine called the Roux limb. This forms a "Y" shape. The food you eat then bypasses the rest of the stomach and the upper part of your small intestine, reducing the amount of fat and calories you absorb from the foods you eat. This surgery is more complex than a sleeve gastrectomy, and the possibility of developing post-surgery complications will be slightly higher.
The best results can be seen about a year after surgery, and the surgery can be especially helpful for patients with diabetes or metabolic syndrome. About 80% of morbidly obese patients with diabetes fully recover after the bypass surgery, and no longer need to take blood sugar medications.

Skin and Plastic Surgery

Refers to abdominoplasty and other treatments used to solve the skin problem after weight loss.

Do I need weight loss/ metabolic surgery

Eligibility of the surgery depend on the following three conditions: 

1. Body Mass Index (BMI) 

Body mass index (BMI) = weight (kg) / height (m2) 

2. Whether you have type 2 diabetes (T2DM) 

3. Whether you have metabolic syndrome

The following group may consider weight loss/metabolic surgery:

1.Age ≥ 18 and < 65 years

2.Patients with a BMI ≥40 kg/m2 (32.5 kg/m2 for Asian population) without coexisting medical problems and for whom bariatric procedures would not be associated with excessive risk

3.Patients with a BMI ≥ 35 kg/m2 (27.5 kg/m2 for Asian population) and ≥ 1 severe ORC (Obesity Related Complication) remediable by weight loss, including T2D ( Type 2 Diabetes Mellitus ), high risk for T2D (insulin resistance, prediabetes, and/or MetS), poorly controlled HTN, NAFLD/nonalcoholic steatohepatitis (NASH), obstructive sleep apnea (OSA), osteoarthritis of the knee or hip, and urinary stress incontinence, can consider a bariatric procedure

4.Patients with BMI 30 to 34.9 kg/m2 (25 to 27.4 kg/m2 for Asian population) and T2D with inadequate glycemic control despite optimal lifestyle and medical therapy

Reference:

¹.2019 Chinese Obesity and Type 2 Diabetes Surgical Treatment Guidelines

².Lancet: Diabetes & Endocrinology