Obesity is caused by excess fat accumulation in the body. This is a gender-neutral disease, and more or less affects everyone the same way. While a multitude of health-related risks are associated directly with obesity, many pathologies enable gain in weight and also make it an arduous task to shed some pounds. A standard way of concluding if you’re overweight or borderline obese is to calculate your body mass index (BMI). All you need for this calculation is an accurate weight (in Kilograms) and height (in meters), however, these units can be easily converted to and from pounds, centimeters, or ft. The simple formula is to divide the weight in kilograms by the square of height in meters. The resultant BMI can then be matched with the following paradigm:
BMI (kg/m2)
What It Means
<18.5
Underweight
18.5-24.9
Normal
25-29.9
Overweight
>30
Obese
When you calculate the BMI a few times, you will realize that a few extra kilograms make a lot of difference since after reaching a certain age, the only variation between height and weight is in weight. A key point to remember here: BMI does not differentiate between body types. Your BMI may classify you as obese when you are only muscular or pregnant. Therefore, it is not the ultimate test of your body health under every circumstance but an accurate comparison index besides that.
Nevertheless, obesity has now become a pressing problem worldwide but especially in the developed regions. This imposes a burden on the healthcare system as obesity never sustains on its own. It is not how the human body is designed, and it certainly impacts the person in more than one way: all of which are severely detrimental if not considered as such in due time. Obesity without any underlying condition such as metabolic disorders is mainly caused by a long-term ignorance of a balanced diet and lack of physical activity.
However, when obesity impacts not just an individual’s mental health but also bleeds into other consequences such as reproductive health, the disease becomes ten times as serious and of concern.
Infertility in Women
Several studies have successfully drawn a link between obesity and infertility in women. Data suggest Polycystic Ovary Syndrome(PCOS) is associated with obesity, thus leading to infertility. Although the underlying mechanism of PCOS is not precisely understood, insulin resistance is often seen to be at the foothold of the syndrome. Influence of Obesity is further confirmed in nonobese women with PCOS who are not as frequently diagnosed with Insulin Resistance. Moreover, even in an otherwise normal weight female, the abdominal pattern of fat can decrease fertility. In fact, this may be more detrimental than being obese overall.
The way in which obesity affects reproductive health is predicated on metabolism. Altered follicle production and complications in embryo development are found to be associated with steroid metabolism and other adipokines(signaling molecules of metabolism). Consequently, an overall poor ovarian response in obese women causes reduced oocyte (egg) retrieval.
Moreover, even miscarriages are more common in obese women. Nevertheless, there is also some discrepancy in the data for obesity and infertility due to a variation in what is considered as the endpoint for obesity to start associating it with infertility. As a general rule of thumb, BMI and infertility are linked when the former is above 30.
Infertility in Men
Contrary to the responsibilities of a female body that produces eggs and becomes the site for fertilization and implantation, the reproductive health of men is majorly equitable to the health of their sperms. While obesity might directly impact androgen production, it may also play a role in Erectile Dysfunction, which influences the delivery of sperm. Studies have reported a prominent decrease in the levels of free testosterone in the blood in obese men. The levels of testosterone are found to be associated with impaired stimulatory and inhibitory processes.
Even though obesity is not as widely studied in men as it is in women, the association of abnormal weight with men’s infertility can not be ignored. Hence, to circumvent health issues arising from being overweight or obese, the minimally invasive bariatric embolization procedure is now available in Pakistan, conducted by the pioneer of embolization procedures Dr. Imtiaz Ahmed, who is a consultant Endovascular surgeon and an Interventional Radiologist.
Treatment For Obesity: Bariatric Embolization
Infertility in women and men who are obese can be restored once the underlying reason is addressed i.e. excess weight. Bariatric embolization is a minimally invasive alternative to the infamous bariatric surgery, which comes with a glut of side effects. On the contrary, Bariatric Embolization works on the same principle but comes under the umbrella of Interventional Radiology. This not only increases the precision of this minimally invasive endovascular procedure and makes it many fold effective but also reduces the recurrence rate and post-procedure patient noncompliance.
To delineate, Gamma block bariatric arterial embolization is performed under 3-dimensional live imaging to precisely identify the vessels leading to the fundus of the stomach. This innovative procedure was first introduced by Dr Imtiaz Ahmad in 2017 and since then has been performed successfully on hundreds of patients with excellent results to date. Microcatheters are guided under imaging to either the radial or the femoral artery, which then reaches the left gastric artery, right gastroepiploic artery and short gastric arteries supplying arterial blood to a specific area in the gastric fundus. Embolization, too, is performed under image guidance, which blocks the blood supply to the fundus; the part of the stomach ”Hunger center” that releases hunger hormone(ghrelin). Consequently, ghrelin is inhibited, reducing the feeling of hunger in the patient. As a result, the patient can focus on reducing weight through physical activity and not get distracted by his/her hunger pangs.
Weight loss through Gamma block bariatric arterial embolization has the potential to tackle the serious epidemic of obesity and infertility. If you are tired of seeing the weighing scale reading and depressed over getting repeatedly negative pregnancy tests, it is time to consider Bariatric Embolization. In Pakistan, you can consult Dr. Imtiaz Ahmad through an appointment in Karachi or Lahore.
Information about Gamma block bariatric arterial embolization treatment strategies. Treatment of obesity and saying goodbye to the extra inches shaking your confidence. Bariatrics is a field which studies therapies pertaining to weight loss and management. This includes surgical procedures and behavioral therapies. Gamma block bariatric arterial embolization treatment strategies (Dr Imtiaz Ahmad is the pioneer of this technique and named it as Gamma block bariatric arterial embolization in Nov 2017 after performing the first ever Gamma block bariatric arterial embolization procedure in Karachi Pakistan)also fall under the umbrella of this field and is a modern approach towards treatment of obesity. Approximately, 39% of the world’s adult population is suffering from either obesity or being overweight.
A person is regarded as obese if his/her body mass index (BMI) is greater than 30kg/m2 in which case, they can make good use of Gamma block bariatric arterial embolization treatment strategies. Obesity may occur due to metabolic dysregulation which could be genetic, lack of physical inactivity, diseases such as PCOS in women or simply because of overeating. Making balanced lifestyle choices is the way forward towards losing all that extra weight.
However, many men and women try to fight obesity by incorporating these lifestyle changes but are often demotivated by the weighing balance’s consistent reading. This may be due to a disease, medication, or psychological stress. Bariatric surgery for weight loss is often advised to people that are suffering from diseases that have either occurred due to obesity or are getting much worse because of it. These patients may have a BMI of 35–40 kg/m2 which is alarming and must be addressed in due time. Bariatric surgery has been around since a while and has proved beneficial. Average weight loss with bariatric surgery has been about 5 to 15 pounds in only the first 30 days. However, bariatric surgery is invasive and therefore, variations to the procedure have been introduced under interventional radiology.
What are the health risks following Obesity?
Obesity imposes several health risks and becomes the starting point of multiple chronic diseases. Ranging from metabolic dysfunctionality to cardiovascular and respiratory diseases, obesity is a defining factor in their progression. It is easy to understand why excess fat in the body would be so detrimental to health. Greater body mass affects almost every part of the body, from bones to muscles and from heart to brain, every organ faces the consequence. Risk of getting diabetes mellitus type 2, hypertension, osteoarthritis, coronary heart disease, respiratory problems, and some cancers, increase manifolds because of obesity. Moreover, in the recent age of social media, selfies, and fashion, being overweight or obese also contributes towards lower self-confidence, eventually leading a person into depression. Health risks following obesity and increasing mortalities have shifted attention towards studying ways in which weight could be reduced or the process of weight reduction could be hastened.
Treatment Of Obesity
The most obvious treatment plan for losing weight is to strike a balance between physical activity and healthy eating. It is no secret that losing weight is less about what you do to shed it and more about how consistently you are doing it. It is a lifestyle shift and being aware of the choices you make in your day-to-day routine. Special diets include intermittent fasting, calorie restricted diet and keto diet, to name a few. Most people require external help for their weight management where specialists plan a personalized routine for a person and conduct sessions to check up on the progress. Weight management programs under a specialist have proven more beneficial than being on your own and trying to lose weight since there is little accountability in the latter case.
Unfortunately, in some cases, a good diet and greater physical activity is also ineffective. Weight loss medicines and devices are advised to people who do not respond to management therapies, but it comes as no surprise that anti-obesity medications come with their fair share of side effects. Additionally, bariatric arterial embolization for weight loss has gained attention as being a minimally invasive procedure for obese people with comorbidities.
Gamma Block Bariatric Arterial Embolization
While the main cause of obesity remains ambiguous, hormones have been linked with controlling hunger, appetite, and weight gain by signaling the brain. Some of the hormones involved in the appetite regulation include oxyntomodulin, cholecystokinin, adiponectin, and ghrelin. Ghrelin is a hormone made from peptides and is released from the PD1 cells of the fundus, which is an important part of the stomach. Release of ghrelin is directly proportional to the food intake. Studies show that hunger increases on administration of ghrelin in subjects and during fasting or weight loss diets, levels of ghrelin rise, while once the hunger is quenched, ghrelin levels decrease. This variation points towards its role in hunger management.
The decrease in ghrelin level has been reported after bariatric surgery and believed to be associated with the weight loss process. Understanding the role of ghrelin is important to rationalize the bariatric embolization procedure which is an improved version of bariatric surgery. Fundus contributes to producing 90% of the ghrelin in the body. Blood supply to the fundus of the stomach is through the left gastric artery. right gastroepiploic artery and Short gastric arteries.
Dr Imtiaz Ahmad is the pioneer of Gamma block bariatric arterial embolization
procedure. This is a highly improved and precision guided procedure in which three blood vessels supplying the gastric funds are targeted as compared to rest of the world where only 1-2 blood vessels are targeted. The first ever “Gamma-Block” was performed in Pakistan in the month of Nov 2017. Patient was a 55 year male who lost approximately 67 pounds over a period of 3 months.
The procedure is a non-surgical alternative to bariatric surgery and does not involve the removal of any part of the digestive system. This aspect makes it minimally invasive yet achieves a similar goal to that of bariatric surgery. Gamma-block procedure is performed under image guidance. Catheter is introduced through the radial or the femoral artery to reach the left gastric artery,right gastro-epiploic artery followed by short gastric arteries supplying the Gastric fundus . Once image guidance confirms the correct position, embolization of the arteries is performed to disrupt the blood supply to the fundus. where “Hunger Center” The 90% ghrelin released from the” Hunger Center” located in gastric fundus causing hunger and overeating in already obese people is now “significantly”inhibited. Weight loss and management now yields much more promising results.
It is crucial to understand that while bariatric arterial embolization alone can prove quite effective, for an enhanced outlook, lifestyle changes and pharmacotherapy may become adjuvant to the treatment. It is helpful to remember that sometimes a loss is also a gain.
