Did you know that obesity is the most common illness in Western countries? Eastern countries however are steadily catching on the fat trend. Read on to learn more and fi nd out our rather drastic alternatives to shedding that persistent fat!!

We inevitable gain weight during the festive season, when we face temptation in the form of chocolates and cakes piled upon our plates by well-meaning friends and relatives. How much is considered unhealthy and what constitutes a healthy weight in the first place?

HOW HEAVY IS HEAVY?
First, calculate your Body Mass Index (BMI). This is done by dividing your weight (kg) by the square of your height (m).

If you are overweight, you face the risk of suffering from a myriad of health problems, including heart disease, stroke, diabetes, hypertension, sleep apnea and certain cancers.

Although it is beneficial to lose weight by changing your diet and getting regular exercise, it doesn't work for everyone. Most people lack the motivation to control their weight and end up going to a doctor for prescribed medication (such as orlistat or sibutramine) or even surgery when their weight spirals out of control. Here arethe alternatives you might resort to, when going for weekly workouts and eating less doesn't seem to help

ORLISTAT
Designated as a prescription drug in other countries, orlistat can also be bought without a prescription from any pharmacy. It goes by the brand name of Xenical and should not be taken for more than 2 years.

Xenical targets the absorption of fat in your body, hindering the activity of enzymes which break down fat taken in your meals. This results in 30% of the fat consumed passing through the gut undigested. If you skip a meal or take a meal without any fat, there is no need to take that dose.

Where does all the undigested fat go too? Of course it gets excreted partially unchanged, leaving you with oily stools or discharge and fl atulence. You may also experience abdominal pain and urgency in moving your bowels. Symptoms are generally mild and occur mainly after meals with high fat content. The absorption of fat-soluble vitamins like Vitamin A, D, E and K may even be impaired and it is recommended that you take multi-vitamins for supplementation.

Seek the advice of your health professional for more information before you embark on any medication for weight loss, especially if you have concurrent health problems or are taking other medication or supplements.

SIBUTRAMINE
Sold under the brand Reductil, sibutramine is more potent than Xenical and is only available under a doctor's prescription. It makes you eat less and therefore slows down weight gain.

Chemicals stored in nerve cells transmit messages and are recycled after they pass on the message. Two of these chemicals (neurotransmitters), serotonin and noradrenaline, affect appetite. Reductil acts by preventing the reuptake (and subsequent recycling) of these two chemicals in the brain, therefore increasing the amount of free neurotransmitters. This gives you the feeling of satiety and increases the resting metabolic rate.

Proper medical supervision is pertinent during usage of the drug. It should not be taken for more than a year, unless as instructed by your doctor. This drug may increase the rate of your heart. The doctor prescribing this will check your blood pressure and pulse rate regularly.

GOING UNDER THE KNIFE
There are many procedures for weight loss, two of which will be covered in this article. For those who are looking at weight loss at a specific area, such as the thighs or stomach, liposuction can be done. However, only 1 to 2 kg of fat is removed at one time. For those who want something more longterm and wish to curb their appetite, lapband surgery is another alternative.

LIPOSUCTION
Raffl es Hospital offers Waterassisted Liposuction which involves a powerful jet of water carving out the fat to be removed. Both fat and water are subsequently sucked out and the procedure is also ‘less invasive because no tissue is violently damaged.'

There is less pain, swelling and fewer blue patches. Blood loss is signifi cantly reduced as compared to other techniques of liposuction. Far smaller quantities of analgesia are required and no large quantities of fluid remain in the body. Overall procedure time is reduced, and the patient can return home after a night's rest.

After a short break of three to four days from physical activity and work, the patient can resume daily activities. Special pressure garments have to be worn for about three weeks to prevent swelling and accumulation of blood clots in the treated area. Depending on the patient's condition, a programme of lymphatic massage may help to smoothen out treated areas and lead to quicker recovery.

Liposuction is definitely a good method for body shaping and removal of small deposits of fat on localized anatomical zones on the body. Costs vary from $3,000 to $4,000 per area treated.

LAPBAND SURGERY
A silicone band with a balloon on the inner side is placed around the upper part of the stomach, creating a sense of fullness. The patient eats less, leading to weight loss. Connected to a reservoir placed under the skin, the band is adjusted by the surgeon once every 3 to 6 months as weight loss progresses.

The insertion of the LapBand is done through a laparoscope, which carries less risk for obese patients as they recover quickly, getting out of bed within 12 hours. After surgery, the patient takes only liquid and pureed food for one month before the band is tightened. Regular follow-ups are required and weight loss takes place over a period of 18 to 24 months. During this period, dietary and lifestyle changes are required.

Dr Ravi from Mount Elizabeth Hospital says, "Lapband surgery has a much lower risk of major complications and mortality compared to other bariatric operations. Because of the simplicity and low risks, the Lap-Band is becoming the choice for many patients who are informed about bariatric surgery. The single most important factor as in all operations will be the experience of the surgical team."

"As the band is adjustable, the major advantage is that it can be adjusted to the patient's requirements such as when they get pregnant. This is not possible with other operations. The band can be removed if required and the stomach returns to its original shape. It is reported that 60-70% of patients with the Lap-Band would have lost at least 50% of their excess weight in 2 years time."

The procedure costs start from $7,000 in government hospitals and from $15,000 in private hospitals.

Click Here to view the pdf version.

Article extracted from Healthy Times, Dec-Jan 08 issue