Definition of Obesity
The ideal weight in the medicine is based on the principle of improving health, generally Body Mass Index (BMI) is used.

1. Body Mass Index (BMI)
The calculation of BMI is using the body weight (unit: kg) divided by the square meter of the height (unit: meters)(BMI = kg/ m2). Normally speaking, the adult BMI shall be between 18.5 and 24, over 24 is overweight, and over 27 is obese, the BMI of over 35 combining with the hypertension, diabetes, etc, and BMI over 40 is considered as morbid obesity. According to the Body Mass Index (BMI), the ideal index is 22 for the life and health, it is the same for both men and women. So the ideal weight calculation is: height (in meters) X height (in meters) X 22.

2. Waistline
The waistline is also a standard to evaluate the obesity, if the men¡¯s waistline is over 90 cm and the women¡¯s waistline is over 80 cm are considered as obese.
According to the different Body Mass Index (BMI), we can also see whether our body weight is ideal or not, the following table is a comparison of the Body Mass Index (BMI):

 

Body Mass Index (BMI)
£¨kg/ m2£©

waistline
(cm)

Overweight

BMI£¼18.5

 

Normal

18.5¨QBMI£¼24

 

Abnormal

Overweight£º24¨QBMI£¼27
Light obese£º27¨QBMI£¼30
Moderate obese£º30¨QBMI£¼35
Severe obese£ºBMI¨R35
Morbid Obese£ºBMI¨R40
Super obese£ºBMI¨R50

Men£º¨R90cm
Women£º¨R80cm



Obesity and diseases
Obesity can cause the following diseases:

Diabetes

The obese patients have lots of fat tissues, this can cause an increased secretion of insulin, the result of high amount of secretion would increase the resistance of insulin and then pancreatic insufficiency, this will further induce hyperglycemia.

Hyperlipidemia, hyperuricemia and gout
They are all related to obesity.

Hypertension
It is related to the increase in the cardiac output and blood vessel pressure.

Coronary artery diseases
Hypertension, high cholesterol and diabetes caused by obesity are the main factors of causing coronary artery disease.

Cerebrovascular diseases and vascular embolism
Hypertension, high cholesterol and diabetes can all cause atherosclerosis and increase the risk of stroke. The obese patients are also easily suffered from vein embolism of the lower extremities and cause embolism of pulmonary and cerebral blood vessels.

Respiratory diseases
Hypoventilation syndrome, Obstructive Sleep Apnea Syndrome

Diseases of the digestive system
The obese patients do not only have high risk of gallstone, but also acute cholecystitis. The nonalcoholic fatty liver disease (NAFLD) can cause hepatomegaly, abnormality of the liver function, hepatitis and even cirrhosis. The obese patients are also complicated with Gastro-esophageal regurgitation disease and cause damage and deformation to esophagus.

Joints diseases
Overweight makes the joints to support more weight, and it can cause degeneration of the joints producing arthritis, especially the knee joints. The obese patients are often suffered from low back pain.

Reproductive diseases
The risk of infertility of the obese women is 30% higher than the normal weight women. They also suffer Polycystic Ovarian Syndrome more easily. Obesity can also influence the sexual function, the excess of the fat can influence the secretion of sexual hormone, causing the reduction of sexual desires and functional disorders, so the obese men have higher chance of impotence.

Dermatologic diseases
The obese patients often suffer friction dermatitis at skin folding area including neck, axilla, genitals and buttocks, causing red and itching eczema. The obstruction of the venous return of the lower extremities can also cause varicose veins and dermatitis.

Psychological diseases
The obese patients easily have Feeling of inferiority and lack of self-esteem, and even depression.

Cancer
The obese patients have higher risk of suffering colon and rectal cancer, prostate cancer, endometrial carcinoma, gallbladder cancer, ovarian cancer and breast cancer.

Body Mass Index (BMI) can also influence the mortality rate. People with higher or lower BMI have more risk of suffering diseases than those whose BMI is between 22-25, and the mortality rate is also higher. Therefore, it is very important to maintain an ideal weight.

Medical Therapy
Items
&
Methods
Nutrition Therapy Pharmacotherapy
Sibutramine / Orlistat
Auricular Acupressure/
Electro-acupuncture
Intragastric Balloon
Principle

Decrease Intake

Increase Satiety
Increase Energy Expenditure
Decrease Fat Absorption

Reduce Appetite
Increase Satiety
Increase Serotonin Level
Stimulate Lipolysis

Endoscopic Placement
Increase satiety

Frequency

Low-calorie diet or balanced diet everyday

Oral intake Qd

Once a week for 12 weeks
Twice a week for 12 weeks

Placement for 6 months

Body Weight Loss 1-2 kg / 2weeks 1-2 kg / 2weeks BWL: 2% / 6 weeks
Waist Circuference ¡ý3% / 6 weeks
BWL: 10 kg / 6 months
Side Effect

Avoid Malnutrition

Palpitation, Constipation,
dry mouth, Insomnia, Anxiety, Arise in BP and HR
Oily spotting, inhibit absorption of fat-soluble vitamins

Infection, Swelling
Bleeding, Bruise, Hollow Organ Perforation

Acid Regurgitation, Nausea, Vomiting, Gastric Ulcer,
Foreign Body Sensation

Outpatient /
Inpatient
Outpatient care Outpatient care Outpatient care 1 day Hospitalization

Laparoscopic bariatric surgery at E-Da Hospital
Bariatric surgery has made obvious progress due to the improvement of the laparoscopic equipment and techniques. Because the operation with laparoscope can reduce the pain and accelerate the recovery time of the patients, avoiding the complication of the wound and heart and lungs, and there is further advantage of nice-looking, therefore, it has become the main stream of the obesity treatment. There are five small wounds on the abdomen of the patient received the laparoscopic surgery. The patient is able to ambulate on the day after the surgery and could discharge two or three days after the surgery. The patients experienced approximately eighty percent reduction in excesses body weight one year after the surgery. E-Da Hospital completed the world¡¯s first single incision transumbilical bariatric surgery in November 2008 and presented at many medical congresses to show our would-leading technique and care.

Laparoscopic Bariatric Surgery
Items\ Methods

Lap-Band

Sleeve Gastrectomy

Roux-en-Y Gastric Bypass

Single Incision Five Ports

Operative Methods

Laparoscope

Laparoscope

Laparoscope

How It Works

Restrictive

Restrictive

Restrictive + Malabsorptive

Excess Body Weight
Loss Ratio

About 60~70 %

About 70~80 %

About 80 %
(Best)

Weight Loss Period

3 Years

1-1.5 Year

1-1.5 Year

Vitamin Deficiency

Mild

Mild

Severe

Operative Risk

Lowest

Low

3/1000

Operation Time

1 Hour

1 Hour

1.5 Hour

Hospitalization
(for international patients)

5 Days

5 Days

5 Days


Service Items
Roux-en-Y Gastric Bypass
Gastric Banding
Sleeve Gastrectomy
Diabetic Surgery
Intragastric Balloon
Treatment of Erectile Dysfunction
Body Contouring
Pediatric Weight Loss
Psychotherapy
Meal Replacement
Medical Treatment
Nutrition Counsel
Acupuncture
Fitness Program
Infertility Treatment