The simplest weight loss methods are adjustments to eating patterns and increased physical exercise. Usually, a combination of reduction of the caloric content of the diet with an increase in physical activity is recommended along with the increase of the amount of water intake. Other methods of losing weight include use of drugs and supplements that decrease appetite, block fat absorption, or reduce stomach volume. Once the excess weight is established, its many related problems such as arthritis, heart problems, diabetes mellitus, high blood pressure, sleep apnea and the heavy load they have to carry all the time make it almost impossible to successfully achieve and maintain weight loss by exercise and dietary modifications alone. Although diet, exercise, behavior therapy and anti-obesity drugs are first-line treatment, medical therapy for severe obesity has limited short-term success and almost nonexistent long-term success. Plastic and Cosmetic Surgery such as liposuction is another method to reduce the fat in specific areas of the body; however, long tem results are disappointing. Therefore, obesity surgery (or bariatric surgery) has been a popular treatment in the war against obesity. Bariatric or Metabolic surgery artificially reduces the size of the stomach, limiting the intake of food energy and also brings about hormonal changes resulting in cure of diabetes mellitus. Intragastric balloon placement by endoscopy is rapidly increasing as a feasible option in patients unwilling or unfit for surgery.

Endoscopic procedures are rapidly gaining popularity due to inherent advantages of avoiding surgery, high safety, reversibility and rapid short term weight loss of 20-30kg. The commonest of these procedures is the Intragastric balloon placement. Intragastric balloons such as the BIB System are non-surgical, non-pharmaceutical aids in the treatment of obesity. The balloon partially fills the stomach and patients report that they have a feeling of fullness. The balloon is placed into the stomach through endoscopy. Once the balloon is inside the stomach, it is immediately filled with sterile saline through a small filling tube (catheter) attached to the balloon. In conjunction with a supervised diet and behaviour modification program, it can help the patient achieve the health and aesthetic benefits associated with weight loss. It may be particularly useful for people considered too overweight or at increased risk for vital surgery. The balloon is usually removed after six months and patients can keep the weight from coming back by modifying their diet and lifestyle subsequently.

Weight Loss Surgery
It generally results in greater weight loss than conventional treatment, and leads to improvements in quality of life and obesity related diseases such as hypertension and diabetes. Laparoscopic surgery has revolutionized Metabolic surgery by greatly reducing problems associated with conventional surgery and is now the treatment of choice.

Procedures:However all modalities of treatment of the problem of obesity require consistent efforts on the part of the patient. A healthy country is built on its healthy citizens and one must all strive to work towards a fit society by regular exercise and judicious diet management to reverse the pandemic of obesity.

Contributed By Dr Amit Thadhani MS, FMAS