Elyzabeth Winda, The Jakarta Post, Jakarta | Body and Soul |
When was the last time you exercised? Have you checked your weight and also your body mass index (BMI) lately? If you haven’t, probably it is time for you to get on the weight scales and pay attention to your own body’s needs.
On Friday, a seminar titled “Hope and Help for Obesity” was held to raise public awareness about obesity.
“Obesity is a severe disease. Everybody is in danger of obesity, especially young people. It is because of drive-through restaurants. We have cars, we have no time to cook at home. Our lifestyles are changing. It is projected that for the first time in the history of mankind, our children will live shorter lives than we will. And this is the dark result from obesity or overweight-related diseases,” affirmed Aaryan N. Koura, a surgeon and senior consultant at Tan Tock Seng Hospital in Singapore.
Obesity was once ranked second as a cause of disease, after smoking. A study published by the American Journal of Preventive Medicine in 2010, however, showed that the quality of life and years lost to obesity are now equal to or greater than those lost due to smoking.
A person with a BMI of 25 to 29.9 is considered overweight. If the index is higher than 30, one better start to seek the best treatment possible, because that’s the BMI for people with obesity problems.
Approximately 1 billion people worldwide are overweight. If we don’t act now, the number will exceed 1.5 billion people by 2015.
In Indonesia, based on the results of National Basic Health Research in 2010, the number of overweight people is twice that of those who have malnutrition. The result says that 12.6 percent of Indonesians are classified as skinny. Meanwhile, 21.7 percent are classified as overweight or obese.
Obesity has become a global epidemic which can cause death, yet the disease is preventable.
“When one is trying to lose some weight, the first thing that they usually complain about is that it’s really hard to get rid of the weight,” said Grace Judio-Kahl, a physician and weight consultant for the lightHOUSE Clinic Jakarta.
In some severe cases of obesity, intervention by doctors or experts is needed, Grace added. She also explained that there were some other methods to help the overweight slim down.
“We are often told to manage our diet, take some pills, workout, or to do some adjunct therapy such as acupuncture, mesotherapy, electrotherapeutics, etc…. But, still, it is hard to get permanent and significant results. This is called the conventional approach,” she said.
“Most weight loss programs advertised are cosmetic. Meanwhile those who are overweight need more than cosmetic solutions. Cognitive behavior therapy [CBT] is considered effective to help people with obesity problems. It focuses on the behavior that is related to their psychological condition. A weight problem is not merely about nutrition and diet. It also needs holistic treatment,” she went on.
Despite the fact that CBT initially involves medication, educating the patient not to be dependent on treatment or medication is what the therapy is aiming for. The CBT is also applicable for people with eating disorders such as bulimia, anorexia, night-eating syndrome, compulsive overeating, and binge-eating disorder.
“A good weight loss program is not supposed to create [new] eating disorders,” Grace emphasized.
When obesity substantially affects one’s health or a person is classified as morbidly obese and all of the methods already mentioned have been done in vain, one can consider invasive treatment: bariatric surgery. Vertical-sleeve gastrectomies and Roux-en-Y gastric bypasses are two commonly performed procedures in the United States.
“In a vertical-sleeve gastrectomy, the surgeon will permanently reduce by 60 to 80 percent the size of the stomach. This reduces hunger by eliminating production of ghrelin [a hormone that appears to be an appetite stimulant],” he explained after the showing an animated video of the surgery.
Meanwhile, Roux-en-Y bypass surgery is also about sharply limiting the amount of food one can consume by sectioning off the stomach into a thumb-sized sac that is connected to a portion of the small intestine. The audience held their breath while the animated video of the Roux-en-Y-bypass — considered the gold standard, according to Koura — was demonstrated.
After surgery, one still has to maintain a healthy lifestyle (or the weight will be regained) and there will likely be some side effects due to the rearrangement of a person’s internal organs.
The surgeries mentioned above, however, still have some pros and cons. According to Grace, in Indonesia, the surgery has led to one patient death and sent several others to the ICU.
“We don’t have doctors in Indonesia who specialize in bariatric surgery yet. It is a matter of life and death we’re talking about. That’s why we refer our [morbidly obese] patients to foreign doctors abroad. There’s still a very long way to go. Hopefully this issue will move doctors to learn more about the surgery. Also the government should be more attentive to obesity cases in the country,” said Grace.
The formula for surgical success, as Koura explained, was 25 percent surgical procedure, 25 percent program/dietitian and group support, and 50 percent “you”.
But the most important thing is, “It’s not to late to go out and exercise and live a healthy live,” as Koura said at the beginning of the seminar.
