What is obesity?
The terms overweight and obesity are often used interchangeably although there is
Overweight occurs when the body takes in more energy than it consumes over a longer
period of time. The absorbed energy corresponds with calories. The excess calories
are then stored as fat.
Obesity is a serious form of overweight which can give rise to serious side effects,
in which case we use the term morbid obesity. These side effects include: high blood
pressure, diabetes, cardiovascular disease, osteoarthritis, respiratory problems,
mental problems, etc.
The BMI or Body Mass Index allows us to determine the extent of the overweight.
This value is calculated as follows:
(Body weight in kg) divided by (height in meters x height in meters)
E.g., 92 divided by (1.86 x 1.86)
- BMI between 20 and 25: ideal
- BMI between 26 and 30: overweight
- BMI greater than 30: obesity
The circumference of a person’s waist is also a measure for determining overweight
Normal waist circumference is less than 80 cm in a woman and less than 94 cm in
a man. Any values above these reference values point to obesity.
The treatment of obesity
Obesity is becoming an epidemic and later in life can give rise to several complications,
such as diabetes, hypertension, cardiovascular disease, joint pain and others. A
wide range of treatments is available, both non-surgical (diets, slimming pills,
gastric balloon, exercise programs ...) and surgical, including gastric band surgery.
In consultation with you we will determine whether you qualify for the surgery.
You will be clearly informed about what the operation entails, about the preliminary
examinations, the operation itself, the follow-up treatment and the results you
can expect to see. If you are extremely obese, you may need to follow a special
preoperative diet to reduce the amount of fat in your abdomen and / or an enlarged
liver, which may complicate the surgery. We will also enquire about past illnesses
or operations you have undergone and any medication that you are taking. This can
be important for the anaesthesia and surgery.
If you are extremely obese and you are considering surgery you always need to inform
yourself properly beforehand: what does the surgery entail, what can you expect,
etc.? There are actually several types of interventions but all are very different
when it comes to the gravity of the surgery, the risks during and after surgery,
whether or not the surgery is reversible, the adaptability and the results. An intervention
to combat obesity is not a "quick fix" and must be carefully planned and executed
in an informed manner. Please also note that the operation is only part of the procedure:
a tailor-made diet, regular exercise, sports and especially your enthusiasm and
motivation are equally important.
During this operation, which is carried out using keyhole surgery, a large part
of the stomach is stapled and subsequently removed, converting your stomach into
a narrow tube. As is the case with gastric band surgery food intake will be dramatically
reduced meaning the patient will lose weight.
Here the stomach is stapled and divided leaving a small pouch at the top of the
stomach, which is then connected with the small intestine, so that the “large stomach”,
the duodenum and the top of the small intestine is bypassed. This intervention is
generally used for very obese persons and persons who ingest a lot of sugars and
sweets. The various surgical treatments for overweight are of course offered in
conjunction with dietary measures and exercise therapy.
The gastric balloon:
This is a balloon, which is inserted in the stomach by means of a gastroscopy (tube
through the patient’s mouth into the stomach) of the stomach with the intention
of creating a sensation of satiety quickly and therefore ensuring that the patient
will eat less. After six months, this balloon is removed.
The gastric band:
A band or ring is appended around the upper part of the stomach by means of keyhole
surgery (laparoscopy). A small stomach is thus formed that only allows the patient
to eat small amounts of food. The obesity surgical team consists of Dr Marc Focquet
and Dr Joost Van Der Sijpt.
Gastric band Operation
Using keyhole surgery (laparoscopy) a band or a ring is tied around the upper part
of the stomach forming a small stomach that only allows the patient to ingest small
amounts of food.
The operation takes about 45 minutes and is performed under general anaesthesia
(you are fully asleep). The tube, which serves to tighten the band through the injection
of a saline solution exits the abdomen and is attached to the reservoir that is
inserted subcutaneously. After the surgery you will have 5 small scars.
The advantages and disadvantages of the operation
After surgery, you need to limit the amount of food and stop eating when you experience
a feeling of satiety. You need to set aside enough time to eat your meal and chew
it properly. It is important that you "learn to listen" to the band, otherwise you
may experience troubles such as gagging (and actually vomiting), a sense of nausea,
mild pain in the stomach or the breastbone and sometimes also acid regurgitation.
Usually the band is adjusted for the first time six weeks after the surgery whereby
the band is filled with a sterile saline solution with a small almost painless injection.
This tightens the band slightly and has the advantage of limiting or restricting
the food intake, which in turn will give rise to more weight loss. On average, 3
to 4 adjustments are required.
The most common complications are: a technical problem with the tube or reservoir
(usually easy to solve under local anaesthesia), the "slipping" or the sliding upwards
of one part of the stomach through the band so that a blind pouch is created above
the band resulting in constant vomiting, pain and the inability to eat or drink.
The immediate treatment is to remove the fluid from the band; sometimes a new operation
The morning after the surgery an x-ray is made to check the position and patency
of the band. If everything is fine, you can leave the hospital. Further treatment
consists of analgesics and blood-thinning injections to prevent clot formation and
pulmonary embolism. After ten days, the waterproof patches can be removed. During
the first three weeks you must adhere to the dietary guidelines: the first two weeks
you can only eat liquids, from week 3 you can try soft food (mashed potatoes, fish
..), then normal food but in limited quantities.