Expert Weight Loss and Metabolic Surgery in Sydney

Causes of Obesity:

Obesity is a multifactorial disease process that affects nearly every organ system in the body and is one of the largest health crises in Australia. Obesity was long thought to be an issue with willpower and eating habits. However, we have learned that obesity is much more complex and has both controllable and modifiable factors in addition to some that are not modifiable.

These factors include:

• • Genetics
  • Health conditions
  • Medications
  • Gut microbiome
  • Age
  • Environment
  • Metabolism
  • Activity level
  • Mental or emotional trauma
  • Smoking
  • Social Economic
  • Pregnancy
  • Diet
  • Sleep Deprivation

In Australia, more than one-third of the population is facing obesity, its side effects and possible metabolic derangement. More than half of the population is overweight. Contrary to popular belief, body weight is not regulated by diet alone. The medical world has found that a number of factors determine one’s body weight, such as genetics, environment, emotional trauma, and daily activity. Obesity is a complicated worldwide health concern.

While there are other factors involved, a healthy and non-excessive diet is still very important. Each individual still needs to examine the causes of obesity that can be controlled. There isn’t a cure-all for obesity but, Bariatric Surgery can counter the effects of some of the causes and may improve some health risks.

It’s important to note that obesity is not yours to manage alone, and there is help that is tangible and manageable.

Effects of obesity:

Obesity is a chronic disease. This, in turn, is a risk factor for many other chronic and acute health issues. Obesity furthermore may worsen these existing health conditions.

Common Obesity-Related Health Risks:

• • Type 2 diabetes
  • Heart disease
  • Menstrual irregularities and infertility
  • Cancer
  • Sleep apnoea and other respiratory problems
  • High cholesterol
  • High blood pressure
  • Stroke
  • Osteoarthritis
  • Fatty Liver disease and gallbladder disease
  • Venous disease
  • Acid reflux

Obesity-Related Cancers:

• • Colon and rectal
  • Oesophagus (Gullet)
  • Stomach
  • Meningioma (Brain tissue and spinal cord)
  • Breast (post-menopausal women)
  • Thyroid
  • Multiple myeloma (blood cells)
  • Liver
  • Kidney
  • Gallbladder
  • Pancreatic
  • Uterine
  • Ovarian

Holistic surgical approach:

Our pledge:

We understand that no two situations, health status or lifestyles are the same. Dr Manju and his team would prefer to help you understand the extent of your particular case, and how different surgical options may have more benefits than others. We pride ourselves in walking with the patient through their journey from prehabilitation, pre-operative assessment, surgery and long-term follow-up to achieve the best outcomes tailored to that particular individual

We recommend that everyone over the BMI of 30 consider a consult to know their options, both medical and surgical.

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Multidisciplinary approach:

Hospital:

This isn’t about which hospital is closest. Or who will pay for what? It’s about deciding which weight loss procedure is right for you and finding the right surgeon and right hospital which is equipped to take care of the entire journey from operation to managing potential complications if any to help you reach your goals.

If you’re going to get it done, get it done right.

Surgical Options:

Dietary: The medical management of weight loss is limited in treating obesity. Most patients regain most of the lost weight after the diet has ended. Some may experience failure with multiple diet plans, resulting in frustration and unhappiness.

Pharmaceutical: Both over-the-counter and prescription drugs for the treatment of obesity have some effects but also have serious side effects. In fact, some of these medications are harmful in patients who have a number of illnesses associated with obesity.

The overall costs of treating obesity-related illnesses, in addition to the loss of productivity over the years, are staggering for an individual, not to mention the financial consequences and mental anguish placed on both the patients and their families.

Surgical: Surgical treatment has evolved over the last few decades and many types of operations have been performed for the treatment of morbid obesity. The underlying approach for most of the operations is either to reduce food intake by reducing the size of the stomach, or by limiting the number of calories being absorbed by the body. In addition to providing a lasting form of weight loss, an ideal treatment for the morbidly obese should carry less risk than the disease of obesity itself.

Obesity Surgery Options:

Laparoscopic sleeve gastrectomy

Roux en Y gastric bypass

Single anastomosis gastric bypass

Revision weight loss surgery

Laparoscopic sleeve gastrectomy:

Laparoscopic Sleeve Gastrectomy is one of the primary weight-loss surgical procedures in which a restrictive mechanism leading to early satiety is the mechanism behind weight loss. This is accomplished by removing 70-80% of the stomach on the left-hand side. This results in not only a greatly reduced volume of the stomach but also reduces ghrelin, a gastrointestinal hormone that plays a significant role in appetite regulation and control. Unlike gastric bypass, this does not change the way the stomach and small bowel interact.

Gastric bypass:

The gastric bypass operation comes in various formats. The most common variants are Roux-en-Y gastric bypass and single anastomosis bypass. It involves creating a small gastric pouch and connecting it to a limb of the small bowel. The weight loss here unlike sleeve gastrectomy which contributes to early satiety is achieved both by reduction of the size of the stomach and bypassed small bowel which contributes to a degree of intended reduced absorption. The remnant stomach, although still in the abdominal cavity and connecting to the small bowel does not, physiologically or mechanically, function the same as a normal intact stomach. The format of bypass that would be chosen depends on the anatomy of the original stomach and the medical history of the patient.

First visit:

Dr Manju has a very detailed and personal program tailored for each patient that starts with the first consult. Our goal is for our patients to have continuity of care during the critical post-operative period and to have the support needed while their life is being transformed after their weight-loss surgical procedure. We believe that a structured follow-up is critical for a successful outcome for a patient. It reduces complication rates and improves the long-term success rate. Each patient is considered individually based on pre-operative history, overall health, surgical course, post-operative care and psychosocial environment and factors.

With experience in treating the disease of obesity, we understand the emotional stresses involved in making this life-changing decision.

We are so excited to be a part of this life-changing journey with you. In order for us to provide the best care during your first consult, it is very important that you bring the following items to your visit:

• • A referral from your GP.
  • A list of your current prescription and over-the-counter medications and supplements.
  • Information about all treatments and medications has been tried in the past.
  • Medical records from prior visits that you think may be helpful.
  • Any x-rays and scans done in the past related to the abdomen
  • Insurance information and card

Pre-operative assessment:

Prior to any surgery, certain diagnostic tests need to be performed. Weight-loss surgical procedures are no exception. In fact, in most cases, a more in-depth pre-operative evaluation is needed.

A complete set of blood work prior to the surgery allows the surgeon to comprehensively evaluate the patient’s nutritional status by measuring vitamin and mineral levels. This information would also be helpful for the dietician who you would see as part of the assessment.

Some patients may require gastroscopy prior to their surgery to evaluate their anatomy. Based on the patient’s past medical history, some may be required to have a sleep study, while others may require a complete cardiac evaluation.

As recommended by the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) a complete nutritional and psychological evaluation is required prior to any weight loss surgery.

We work very closely with nutritionists who have a thorough understanding of different weight-loss surgical procedures and the nutritional and supplement requirements that are needed postoperatively. We also work with psychologists who have years of experience in providing the care and counselling needed during the pre-and postoperative periods.

Our office will coordinate and help you complete the preoperative workup.