Dr Ganesh Ramalingam,
Consultant General Surgeon
at Parkway East Hospital
Most of use have tried to control our weight at some point in our lives. However, for some, battling weight issues demands a more substantial solution. We speak to Dr Ganesh Ramalingam , a General Surgeon at Parkway East Hospital to find out more about possible solutions. Obesity has been recognized as a worldwide epedemic for the past few decades, with factors such as genes, high levels of stress, unhealthy eating habits, sedentary lifestyles and psychological problems all contributing to thos rising concern. In addition, obesity is not just a matter of being severely overweight. Other modities are associated with the condition, including:
- 1. Metabolic diseases like Diabetes, Mellitus, Hypertension and Hyperlipidemia
- 2. Cancers like breast cancer and colorectal cancer
- 3. Chronic joint diseases like chronic back pain, and osteoarthritis of the spine, hips, knees and ankles
- 4. Other illness like skin infections, pancreatitis and much more
- 5. Infertility, depression and being a social outcast
Obesity can be a financial burden to one’s family and community,” says Dr Ganesh Ramalingam, a general surgeon at Parkway East Hospital. “Morbid obesity (i.e. having a Body Mass Index of above 35 or above 32.5 for Asians) is likely to be linked to depression and a shorter lifespan. Most people try to lose weight through diet and exercise, but, for morbidly obese patients, the chances of weight loss of more than 10% is less than 2%, thus leading to the development of obesity management and weight loss surgery (bariatric surgery).”
A Non-Invasive Solution
In mild or moderate cases of morbid obesity, or for patients who are too ill to undergo surgery, an Intragastric Balloon can be inserted into the patient’s stomach via a gastrocopy. “The presence of the balloon simulates the sensation of having a big meal and reduces any feeling of hunger, thus resulting in weight loss of about 15% after 6 months, ” explains Dr Ganesh.
The Surgical Approach
A more invasive procedure would be the Laparoscopic Sleeve Gastrectomy, done by staplign the stomach, converting it into a long narrow tube and limiting its capacity. “This procedure also removes the fundus of the stomach, which is responsible for the production of the hormone which stimulates senations of hunger,”adds Dr Ganesh. Laparoscopic Adjustable Gastric Banding is another invasive procedure which involves placing a band, with an inflatable balloon on the inside, around the upper portion of the stomach. “The band will be tightened progressively over a period of many months and restricts the amount of food the patient consumes,” explains Dr Ganesh. Both procedures can result in excess weight loss of 60% over 1 to 2 years, with minimal complications.
For long term weight loss and improvements in obesity-related medical problems, the recommended procedure is the Laparoscopic Roux-ex Y Gastric Bypass, a procedure where a small pouch is made in the upper stomach which is then connected directly to the middle portion of the small intestine, thus bypassing the rest of the stomach and the upper portion of the small intestine. The amount of intestines left to absorb calories is now much shorter, causing a decrease in the absorption of calories.
“This procedure gives the best results over a long period of time,” stresses Dr Ganesh. “Studies show that Diabetes Mellitus improves almost instantly after the procedure due to hormonal changes that occur after bypass. We perform this procedure to for patients who have severe Diabetes Mellitus, Hypertension and high cholesterol.” Regardless of these options, Dr Ganesh strongly believes that diet and lifestyle changes are the key to managing obesity in the long run. A good balanced diet and regular exercise must be in part of the daily routine for all solutions to be successful.
Ultimately, Dr Ganesh feels that these procedures are less about losing excess weight and more about providing patients with opportunities, socially and career-wise. “Weight management surgery offers morbidly obese patients the chance to be healthier, happier and to lead more productive lives”, he says.
For enquiries or to schedule an appointment, please contact
Parkyway East Patient Assistance Centre
321 Joo Chiat Place, Singapore 427990
24-Hour Helpline: +65 6377 3737
Email: [email protected]