Surgery the fi­nal choice for weight loss

Irish Examiner - Feelgood - - Health - www.mater­pri­

MR John Con­neely is a con­sul­tant sur­geon at Mater Pri­vate Hospi­tal, Dublin, and has a spe­cial­ist in­ter­est in the man­age­ment of weight loss and min­i­mally in­va­sive bariatric surgery:

“In Ire­land to­day, one in 20 adults have an obe­sity-re­lated dis­ease such as di­a­betes, heart dis­ease, sleep ap­noea and fer­til­ity prob­lems. We are quickly be­com­ing the most obese coun­try in Europe. World­wide it is es­ti­mated that as many as 700m peo­ple are obese.

“A healthy weight is one that is right for your body shape and height and is based on your body mass in­dex (BMI) and your waist cir­cum­fer­ence. There are lots of cal­cu­la­tors avail­able to check your BMI which in­volves mea­sur­ing your height and weight to cal­cu­late your body’s sur­face area. You can check these on­line or next time you visit the fam­ily doc­tor ask the nurse to cal­cu­late it for you. In con­junc­tion with your BMI, also mea­sure your waist cir­cum­fer­ence.

“Mea­sur­ing your waist can help you find out how much fat you store around your stom­ach. Peo­ple who store fat around their stom­ach are more likely to de­velop weight-re­lated health con­di­tions.

“Weight man­age­ment is a life­long pro­gramme that starts in child­hood with cre­at­ing a nor­mal at­ti­tude to diet and ex­er­cise. Reg­u­lar phys­i­cal ac­tiv­ity burns calo­ries and builds muscle, both of which help you look and feel good and keep weight off. Walk­ing the fam­ily dog, cy­cling to school, and do­ing other things that in­crease your daily level of ac­tiv­ity can all make a dif­fer­ence. If you want to burn more calo­ries, in­crease the in­ten­sity of your work­out and add some strength ex­er­cises to build muscle. The more muscle you have, the more calo­ries you burn, even when you aren’t ex­er­cis­ing.

“An un­in­tended side ef­fect of modern tech­no­log­i­cal progress is that we tend to spend a lot of time in front of screens. Set rea­son­able lim­its for your chil­dren on the amount of time they spend watch­ing TV, and us­ing com­put­ers and tablets. When plan­ning meals avoid big por­tions and sug­ary drinks, which are empty calo­ries that con­trib­ute to obe­sity. Eat 5 serv­ings of fruits and veg­eta­bles a day.

“Fruits and veg­eta­bles are about more than just vi­ta­mins and min­er­als they also con­tain fi­bre, which means you will feel full. Don’t skip break­fast. Break­fast kick starts your me­tab­o­lism, burn­ing calo­ries from start of the day and giv­ing you the en­ergy to do more. Peo­ple who skip break­fast tend to eat more later on. In fact, peo­ple who skip break­fast tend to have higher BMIs.

“For some, tra­di­tional weight man­age­ment strate­gies fail and other av­enues need to be ex­plored such as surgery. In this case, a lot of dis­cus­sion is re­quired. The first step is to dis­cuss this with your doc­tor and if you meet the cri­te­ria it is okay to get a re­fer­ral to a spe­cial­ist sur­geon and dis­cuss your op­tions. Many of the pa­tients we will see have been di­et­ing for most of their lives with­out suc­cess and are at a stage where weight loss surgery is con­sid­ered the best op­tion for them.

“Weight loss surgery ser­vices in Ire­land are un­der­de­vel­oped. The bariatric surgery pro­gramme at The Mater Pri­vate is a com­pre­hen­sive, multi-dis­ci­plinary ser­vice span­ning 18 months. A per­son­alised multi-dis­ci­plinary team works with pot he ten­tial pa­tients for a min­i­mum of 6 months be­fore surgery, and up to 18 months post-surgery to en­sure their weight-loss jour­ney is a suc­cess. Bariatric teams suc­ceed by help­ing obese pa­tients who have strug­gled for years to re­alise their goal of a healthy weight.

“Surgery is of course not the first op­tion in man­ag­ing weight loss and any­one who is con­cerned about their weight and the im­pact it may have on their gen­eral health should dis­cuss that with their fam­ily doc­tor. Your doc­tors’ ul­ti­mate goal is to pre­vent ill-health through ed­u­ca­tion in life­style changes such as diet and ex­er­cise how­ever they un­der­stand sur­gi­cal op­tions are avail­able to adults who have a Body Mass In­dex (BMI) of 45 or more, or who have a BMI be­tween 40 and 45 with other sig­nif­i­cant dis­eases, such as type 2 di­a­betes, hyper­ten­sion, and hy­per­c­holes­terolemia or sleep ap­noea.”

Work­ing out: Weight man­age­ment is a life­long pro­gramme ac­cord­ing to John Con­neely, of the Mater Hospi­tal.

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