On World Obesity Day, THE WEEK speaks to Dr Nanda Rajaneesh, General and Laproscopic Surgeon, Apollo Spectra Hospital, Bengaluru on what it means to be obese and what can be done about it.
Q: How the definition of obesity has evolved over the past few years?
A: Obesity’s definition formally has not evolved, but informally it has. For an individual to be obese, associated with obesity, they should have some health issues, because many times, some people are born obese, and they remain obese for a longer time, they don't have any health issues.
But as a doctor, I do see a lot of obese girls. Nowadays, young girls, are having pimple issues and looking inflamed, bloated up on the face, and are recently starting to become obese.
Irregular distribution of fat, and swelling here and there. Girls with very large breasts become very heavy and painful, associated with body pains, fatigue, tiredness, and performance levels of the individual going down psychologically and mentally feeling low. So these also should be included as the definition of obesity informally, and that is when I think they are obese.
Q: To what extent do genes play a role in contracting obesity?
A: We always thought there was a genetic connection to obesity but more than the genetic connection, obesity is a familial connection wherein the similar type of foods that you eat in the family lead to obesity, that is one.
In families, there are certain genetic diseases which can cause inflammatory diseases like inflammatory bowel disease, and inflammatory arthritis. These can be very much genetically associated and these are again associated with inflammation and obesity itself. Inflammatory diseases which are genetic will lead to obesity because of depression. Overeating, body pains and fewer activities all go together too.
Q: What are the top three ways in which obesity should be tackled?
A: Immediately, let's not jump to surgery because surgery has its own complications. Secondly, after surgery, obesity can come back unless we know what are the reasons for obesity that an individual has developed.
- Vitamin D deficiency could be a reason for obesity
- Hyperparathyroidism
- Inflammatory diseases in the gut and irritable gut syndromes could be another
- Stress in the family - financial stress, and work stress all play a huge role in obesity
First, the reason for obesity has to be tackled and it can definitely be treated. Next is to follow the patients for at least three weeks, treating all the problems and see how it goes. Evaluating the patient for any underlying diseases is the next and then comes the role of surgery.
The standard of surgery that we recommend now is gastric sleeve resection, which is simple and straightforward.
