Dr Ganesh Ramalingam of G & L Surgical on Battling Obesity

SINGAPORE -�Media OutReach - 13 January 2020 - According to the
Health Promotion Board, one in 10 Singaporeans aged between 18 and 69 is obese.
If left unmanaged, obesity rates
— projected to hit 15 per cent in the next seven years ­– could swell into a
sizeable problem as the condition could lead to such potentially
life-threatening illnesses as heart diseases and stroke. For Dr Ganesh
Ramalingam, a surgeon specialising in
gastrointestinal, bariatric, advanced laparoscopy and endoscopic surgery of G & L Surgical, maintaining a controlled diet and exercise regime are key factors in achieving one’s
weight-loss goals. However, in cases where diets and lifestyle management appear
to be insufficient, patients are advised to consult a doctor for advice on
alternative treatments.

 

What are some
health risks of being obese?

In general,
being obese affects one’s level of physical activity and mental wellness, with
the attendant body pain and breathing problems leading to a low quality of
life. Clinical depression and sleep apnea may also set in.

 

Beyond that, there
are many other long-term health risks that can affect a person with a high BMI
— a person with a BMI that exceeds 25 and 30 is considered overweight and obese
respectively. Some risks include hypertension (high blood pressure), Type 2
diabetes, osteoarthritis, as well as heart, liver and kidney diseases.

 

What are some
non-surgical alternatives available when it comes to weight loss procedures?

Diet and
lifestyle modifications are always the mainstay of weight management. The next
step is usually medication and there are various oral medications available.

 

Another alternative
is an injectable medication called Saxenda, which is approved by the Health
Sciences Authority in Singapore. Saxenda is an injectable pen prefilled with
liraglutide, which is designed to behave like a hormone that regulates one’s
appetite.

 

Another
non-surgical alternative available is Gastric Balloon Procedure, whereby an
endoscopically inserted balloon limits the amount of food consumed due to the
balloon occupying space in the stomach.

 

For patients who
opt for Saxenda as a non-invasive obesity treatment, what dietary and lifestyle
adjustments do you recommend in order for patients to maintain a healthy
weight?

Exercise
and diet control is vital in any successful weight management. Exercise has to
be done at least three times a week and each session should last more than 45
minutes.

 

A diet can be
assessed in terms of the quantity and quality of food consumed. I will tailor a
diet plan befitting of the individual after a consultation with them.

 

What about weight
loss surgery?

There are
many options available such as bariatric surgery which has been proven to
produce long-lasting weight loss results and improve obesity-related conditions
such as Type 2 diabetes, sleep apnoea and high blood pressure, said Dr Ganesh
Ramalingam. Patients generally lose 50 to 60 per cent of their excess weight
within a year of surgery. For an example, like many obese individuals who
resort to weight loss surgery, Mr Nikhil Gangaram had tried dieting and
exercise, but failed to keep his weight down. Unlike most of them, however, he
is only 19. The experience undergoing bariatric surgery in 2017 to remove part
of his stomach was the “most painful thing” he has ever put himself
through. But since then, the full-time National Serviceman — who is 1.83m tall
and used to weigh 122.8kg on the 27.02.17 — has reduced his food intake
significantly and shed a total of 20.1kg weighing 102.7kg on 07.06.18. It is a
result he considers a “miracle”.

 

Parents considering
bariatric surgery for their teenage children should bear in mind that lifestyle
and diet changes must be made as a family for the weight loss journey to be
successful, said Dr Ganesh
Ramalingam.

 

Patients must be
fully committed in preparing themselves for the surgery.

 

“Preparing for
this major operation can take many months of work. Patients need to show that
they are willing and able to make big changes in their eating and exercise
habits before the surgery,” said Dr Ganesh.

 

With many weight
management options out there, why should someone seek medical advice for
alternative solutions?

Obese or
overweight people may have chronic diseases or health-care issues related to
obesity — for instance, Type 2 diabetes. As a result, they may have experienced
little success despite managing their diet, exercising or trying out
non-medical treatments. In such situations, consulting a medical team may be
more helpful, as they can provide a holistic approach towards the goal of
achieving a better quality of life.