Diabetes Obesity Centre

Persons without diabetes	Persons with diabetes
50% risk reduction for developing new onset of diabetes	Reduction of the blood sugars by 30 to 50%
25% risk reduction in all causes of death	-
10% reduction in total cholesterol	-
30% reduction in triglycerides	Reduction of the need of oral diabetic drugs and insulin
40% reduction of risk of obesity-related cancers	-

Obesity is a chronic disorder with multiple serious health complications. Previously it used to be a concern only for developed countries but now it is becoming a problem for developing countries as well.

There is a global epidemic of obesity with prevalence as high as 30 to 40% in some regions. In India approximately 139 million people are obese.

Obesity impairs quality of life and reduces life expectancy. All the effects and complications of obesity appear at lower body weight and at a younger age in Indians as compared to the West.

OBESITY & WEIGHT MANAGEMENT FLOW CHART

Patients are expected to comply with the weight management program as per the given plan. The nutritionist assesses the eating habits and gives individualized meal plan and specialist diets.

The fitness instructor assesses the levels of fitness and gives the individualized exercise plan. Based on the medical assessments involving investigations and questionnaires, the physician determines the causes of obesity, identifies co-morbidities and complications of obesity and formulates a treatment plan.
The team discusses the management plan with the patient and sets realistic goals, making the patient understand the benefits of weight loss. The ultimate aim is to support the patient through the whole journey of weight loss.

WHEN YOU LOSE WEIGHT, YOU CAN ALSO CONTROL DIABETES

ARE YOU OBESE?

If you have a Body Mass Index [BMI] of 25 or more, then you are obese. Obesity is caused by a number of factors including a sedentary lifestyle, a high-calorie diet with an excess of fatty foods and various other psychosocial factors. It slowly but steadily takes over your body, slows down your lifestyle and increases your risk of contracting life-threatening diseases like diabetes, hypertension, heart disease and some types of cancer.

BUT DON’T WORRY, HELP IS AT HAND!

With an alarming rise in the number of people with obesity and diabetes across the world, there has been a welcome increase in research to help cure this disease. Besides diet, exercise and an active lifestyle, bariatric surgery has emerged as a successful way to treat obesity and diabetes.

WHAT IS BARIATRIC SURGERY?

Bariatric surgery is a procedure that induces weight loss by altering the anatomy of the stomach and intestines. Two commonly performed bariatric surgical procedures are:

Sleeve Gastrectomy reduces the size of the stomach by surgical removal of a large portion of the stomach.
Gastric Bypass creates a new small stomach pouch and reroutes the small intestines to the new stomach pouch.
Sleeve Gastrectomy Roux-en-y Gastric Bypass.

ADVANTAGES OF LAPAROSCOPIC BARIATRIC SURGERY

Significant long-term loss of weight
Reduction in mortality
Complete or partial remission of diabetes even in severe cases
Single keyhole incision with negligible scar
Improvement in blood pressure and lipid profile
Short hospital stay

The team at Dr Mohan’s has the full surgical expertise to handle different types of surgical interventions such as Roux-en-Y Gastric Bypass, Sleeve Gastrectomy and several others. In case the necessity of bariatric surgery is determined, the team assesses fitness for surgery and ensures that the entire support mechanism involving managing the diet plan for surgery, pre and post operative support and handling psychological issues is present to assist the patient. The patient can opt to take up the surgery after understanding the risks and benefits.

ROLES

Physician

Medical assessments for causes of obesity
Identifying comorbidities, complications of obesity
Formulating a treatment plan
Assessing suitability for bariatric surgery

Intensivist

Diagnosing and managing sleep apnea
Accessing fitness for surgery
Immediate post-operative care

Nutritionist

Individualized meal plan
Specialist diets
Diet plan for surgery
Assessing eating habits
Pre and post-operative support

Clinical psychologist

Motivation assessment
Motivational technique
Screening for psychological issues

Fitness instructor

Assessing levels of fitness
Individualized exercise plan

Surgeon

Full surgical assessment
Explaining types of surgical operations
Explaining the risks and benefits
Expertise in all surgical operations

Weight gain is caused by an imbalance between energy intake [from your diet] and energy expenditure [through activities of daily living and exercise]. Therefore, you can lose weight by cutting down on your energy intake or increasing your energy expenditure, or better still a combination of the two.

Basic rules for a weight loss diet

Cut down on calories

For effective weight loss, you need to cut down your intake of energy [calories] one way or the other. Try reducing your intake by 200 to 300 calories per day. Just by eliminating a banana from your diet, you can reduce your daily intake by 100 calories. Similarly, eating half a serving of fried snacks rather than the full serving would help you cut another 100 calories. You only need to make small sustainable changes to your diet, making sure you get all the essential nutrients in the right proportions.

Restrict fat intake

Fat is the most concentrated source of calories. By restricting fat in the diet, you can reduce the total calorie intake most effectively.

Proteins are your allies – But choose wisely

Protein promotes a sense of fullness and does not, by itself, cause weight gain; however, many foods rich in protein are also rich in fat, limiting their usefulness if you want to lose weight. Overcome this by choosing lean meat and skimmed milk over red meat and whole milk.

No skipping meals

Try not to skip meals, particularly breakfast. When hunger strikes in between meals, munch on healthy fillers like grams and vegetable salad. Start your meal with low-calorie foods such as green salads and clear soups.

Let your plate be your guide

Fill ¾ of your plate with vegetables, greens and whole grams and the remaining ¼ with whole grains. Have an eye on the portion sizes.

All for One, One for All

Seek help from family, friends and support groups so that you can get the encouragement you need. When frustration strikes- as it invariably will at certain times-remind yourself of your long-term goals and the benefits you stand to reap by losing weight.

Tips to lose weight

Follow the commandments to rein in cravings. Be strict with three keys—Right Attitude, Planning and Determination which will help you sail through any occasion or party without gaining unwanted weight.

Avoid skipping meals before a party

Eat something substantial (fibre rich food like oat meal, grams, bran cereal) an hour before you go to the party. This will fill you up and when you arrive, you can eat light. Do not fast all day and then binge at the party. Eat your regular meals so that you don’t overindulge.

Multiply meals, Shrink portions

Eat small meals. Your body needs only a few calories for energy and metabolism. If you eat at regular intervals you are less likely to overeat at night. While partying, offer to bring a healthy, diet-friendly dish to the party. Your host or hostess will appreciate your contribution and you can enjoy the food. Enjoy a big, healthy salad before the meal.

Have lots of water with meals

Drink lots of water (at least eight to ten glasses a day) instead of sodas or mixed drinks as this will help you feel less hungry and thirsty. Eat food with a high water content that will fill you up and help you lose weight. (Examples –tomatoes, cucumber). Avoid standing near refreshments because it is too easy to indulge a few times without considering the fat and calories.

Cut down portion sizes

Control your portions. Small plates are a big help with portion control. If salad plates are available, make them your choice instead of a dinner sized plate. Look at the available choices, hold the plate for a long time and nibble a few edible choices like vegetables, fruits.

Divide before you devour

It is not always what you eat, but how you eat. Pleasure is best when shared. This way your taste buds are satisfied, portion size decreased and calorie intake reduced. Eat so that you enjoy each bite.

Focus on socialisation

While partying, focus on friendship and socialising rather than food. Fill the evening with conversation and meaningful interactions. Walking around and visiting with other guests is a benefit for dieters. If friends are pressurising you to indulge, the best way to respond is to be firm and positive. Rather than saying you can’t or shouldn’t have, say you aren’t hungry and it’s not your favourite. They can’t argue with that.

Schedule your exercise routine

Make exercise an important part of your daily life. Plan your workout in your daily planner and write it down so that you are more likely to maintain the schedule. Find an exercise trainer or a workout partner to help you stay committed.

Separate food from television

Eating, napping, channel surfing-if these consume most of your leisure hours, you will end up gaining weight. Make healthy and light food choices to manage weight. Examples – choose egg white instead of the whole egg, whole-grain instead of refined products, skim milk instead of whole milk etc.

Take breaks to deep breathe

Do you binge eat when you are bored, angry or tense? Decide to do something else to take your mind off food. Relax and take several deep breaths. This will help you distinguish between actual hunger and eating due to emotional responses.

Reward yourself

Book yourself a relaxing body/foot massage you enjoy or buy yourself an outfit that looks good on you. The key to staying happy after all that planning and putting together the time and effort to maintain weight is to reward all your efforts. This will help you stick to your fitness regimen and will help you when you go off-track.

Diabetes Obesity Centre

Services at Dr. Mohan's

BENEFITS OF 5 TO 10% WEIGHT REDUCTION

OBESITY & WEIGHT MANAGEMENT FLOW CHART