Normally BMI is around 18-25. Upper body obesity age of greater health consequences. ( heart disease, stroke, hypertension, diabetes high cholesterol, sleep apnoea)

  • Class 1 obesity BMI (to 30-35)
  • Class 2 – (35-39)BMI
  • Class 3 obesity -BMI 40 and above.

Upper body weight is more health hazard. Waist circumference at the navel Should not exceed half of the Body height of that person.

Anti obesity medications.
( BMI – 30 and above )

1) Phentermine 15 mg / daily. ( most commonly prescribed adrenergic agonist and anti obesity medication in the USA.) maximum-37.5 mg daily.

2)Orlistat ( XENICAL) 60 mg – 120 mg tid Enzyme Lipase Inhibitor Can cause bloating, abdominal cramps and diarrhoea.

3)two in one Phentermine +Topiramate ER 3.75 mg//23mg daily .

4)Naltrexone SR +BupropionSR 8 mg/ 90 mg 1 tab daily, maximum 2 tabs twice daily.
5) Liraglutide and Semaglutide 3.0 mg 2.4 mg were FDA approved initial GLP1 agonists. BMI.40. OR 35. + complication of obesity. May be offered surgery.

BARIATRIC SURGERY is the most effective treatment for most effective treatment fo obesity.

Sleeve gastrectomy :

70’/, of stomach body and antrum removed. Fundus, that secretes appetite stimulating Ghrelin hormone, also is removed.

Roux-en- Y gastric bypass:

A staple partition across the proximal stomach; A small proximal part is connected to jejunam. thus bypassing the reminder of the stomach,duodenums, and Proximal jejunum. Is the 80s often recommended in preference to sleeve to be gastrectomy in type or two diabetes.

Laparoscopic adjustable gastric band.

It is inflatable device; Placed in the stomach. 200 YEARS – DIABETES First recognized around 1500 B.C.E by the ancient Egyptians. A disease person urinated often and lost weight. The term diabetes first was used by a greek physician Aretaeus. ( 80 to 138 C.E ) Mathew Dobson measured the concentration of glucose innUrine. Diabetes is a clinical entity when NEJM was founded in Year (1812) No effective treatment.Diabetes was uniformly fatal in a few weeks to months. Structure of human pro insulin, Glucose metabolism, Other advances, Ten scientists are awarded the Nobel prizes. Insulin resistance, impairedinsulin Secretion. Mile Stones in diagnosis and treatment of diabetes Claude Bernard – ( mid 19th century) Liver plays central role in the regulation of blood sugar.

In 1889, Joseph von Mering and OskarMinkowski found – Removal of the pancreas from dogs , developed. fatal diabetes. That was the first clue that pancreas plays a key role in regulating glucose concentrations. In 1910, Edward Albert Sharpey- Schafer hypothesiized diabetes is due to a deficiency of Chemical, Insulin. In 1921, Frederick Banting handle Charles Best actually reversed diabetes, that had been induced.