GENERAL & UPPER GI SURGEON

MBBS MS FRACS

Dr Govind Krishna is a General & Upper

Gastrointestinal Surgeon providing

consultative and surgical services to

patients in south West Sydney.

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Dr Krishna Sleeve Gastrectomy Gastric Sleeve pdf-image

Dr Krishna’s services include a special interest in providing surgical weight loss solutions for obese patients.

Obesity is emerging as a health epidemic around the world. According to the Centres for Disease Control and Prevention, obesity is rapidly spreading across all regions and demographic groups. Obesity is the second leading cause of preventable death following smoking.

What is Obesity?

Obesity is defined as an excessively high amount of body fat in relation to lean body mass. Obesity is an excess of total body fat, which results from caloric intake that exceeds energy usage. Obesity is viewed as a serious chronic disease which poses a health risk.

A measurement used to assess health risks of obesity is Body Mass Index (BMI).

The BMI describes the relative weight for height. It is measured by dividing the weight in kilograms by the height in meters squared.

This index allows us to compare someone’s weight with the weight of other individuals of different heights. Using the BMI also allows us to calculate the ideal weights for individuals based on their height. The BMI strongly correlates with the total body fat content. It applies to both adult men and women. BMI does not differentiate between body fat and muscle mass. Therefore, body builders and people who have a lot of muscle bulk will have a high BMI but are not overweight or obese.

BMI is usually a good indicator of body fat for most people. Although it doesn’t directly measure body fat, it closely correlates to direct measures of body fat, such as underwater weighing. BMI is also an inexpensive and easy-to-perform method that can help determine if a person’s current weight could potentially lead to health problems.

It’s important to note that BMI is not a diagnostic tool. Whether a person has a high BMI or low BMI, an individual’s personal measurement should be left to a reputable doctor to determine if excess weight is a health risk. Further assessments may need to be completed including:

  • Family History
  • Evaluations of Diet and Physical Activity
  • Skinfold Thickness Measurements

As an example of BMI:

A person who is 170 cm tall and weighs 130 kg will have a BMI of 45 and a theoretical ideal weight of 72kg (calculated for BMI of 25). The excess weight = actual weight(130kg) – ideal weight (72kg) = 58 kg.

What is Morbid Obesity?

It is a disease in which the accumulation of excess fat interferes with the functions of other organs causing serious life threatening health problems.

What are other medical conditions that can be caused by Obesity?

  • arthritis and other orthopedic problems, such as lower back pain
  • hernias
  • heartburn
  • adult-onset asthma
  • gum disease
  • high cholesterol levels
  • gallstones
  • high blood pressure
  • menstrual irregularities or cessation of menstruation (amenorhhea)
  • decreased fertility, and pregnancy complications
  • shortness of breath that can be incapacitating
  • sleep apnea and sleeping disorders
  • skin disorders arising from the bacterial breakdown of sweat and cellular material in thick folds of skin or from increased friction between folds
  • emotional and social problems

What is Bariatric/ObesitySurgery?

Bariatric surgery is a group of procedures that can be used to induce weight loss for patients. Obesity operations can be put into one of three categories

Restrictive: Reduces the amount of food that the stomach can hold and bring a sensation of early satiety but does not interfere with normal digestion of food and nutrients.

Malabsorptive: Shortens the digestive tract to limit the number of calories that can be absorbed.

Combination: There is both a restriction on the amount that can be taken as well as the ability of the body to absorb the calories.

The surgery types can include

  • Reducing the size of the stomach with an implanted medical device (gastric banding) or gastric plication.
  • Removal of a portion of the stomach (sleeve gastrectomy or biliopancreatic diversion) or by
  • Resecting and re-routing the small intestines to a small stomach pouch (gastric bypass surgery or mini gastric bypass with single anatamosis)

Who Should Consider Obesity Surgery?

Obesity surgery is suitable for adults who have:

  • BMI of 40 or greater
  • BMI of 35 or greater when it is combined with a significant health condition that could be improved with weight loss (diabetes, high blood pressure, sleep apnoea, arthritis, etc.)

Long-term studies have shown these procedures coupled with an increase in exercise and change in diet cause significant long-term loss of weight, recovery from diabetes, improvement in cardiovascular risk factors, and a reduction in mortality of 23% from 40%

For more information on our services please contact us.

 

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