Obesity when itself becomes a disease, it is a limitation for the patient. This no longer remains only a cosmetic surgery problem but has to be tackled as an organized effort by many specialties. This is a concern for the patient as well as doctor who is treating.

PATIENT'S CONCERN is that he or she has too much fat deposition in almost all body part, which shows as layers or Tiers. Thick fat apron hangs down from the abdomen to thighs, insides and outsides of thighs are so much bulky that it is difficult to walk. Same is the case with chest and arms. To keep their parts clean is difficult. Walking and other movements are quite limited. Many diseases are associated with obesity and patient bears the brunt of their added problems.

REASONS OF MORBID OBESITY are many. For the interest of every one, I will discuss few of them here:

1. Excessive eating is one of the main reasons. Modern life style has limited activities. Calories intake are invariably more than the required daily consumption. Extra calories are stored in shape of fat in fat cells.

2. Eating habits of now-a-days have more of junk food, juices and soft drinks. Children in particular have more affinity towards chocolates and ice-creams. Very few physical exercise lots of calories intake adds to obesity problem even in childhood.

3. Wrestlers, weight lifters and some sports persons in their younger age do heavy exercises plus heavy diet. But, little later, when this routine is broken, can't keep a control, ends up in morbid obesity at younger age.

4. Accidents and prolong bed rest in some cases adds to the problem of obesity.

5. Ladies after pregnancies, more so after caesarian section operation have tendency to put on which is unstoppable leading to morbid obesity.

6. Uncontrolled excessive drinkers of bear and alcohol on regular basis along with rich food is one major and common cause of morbid obesity.

7. Compulsive eaters are those who cannot stop themselves from eating are in good number as morbid obesity patients.

8. Hormonal derangements are medical problem in some cases. Imbalance in hormones production in Thyroid, Pituitary, Adrenals and some other glands are responsible for morbid obesity.

9. Hereditary factors does play important role. Offspring's of obese parents with familial history are often obese.

EFFECTS OF MORBID OBESITY ON PATIENT'S BODY are many, listed here:

1. Bulky body is an embracement for the patient and family. Laughs, Funny comments and jokes are common. Patient develops complexed feelings. 2. Activities and movements with heavy body are quite restricted and slow.

3. Breathlessness with little effort is common.

4. Blood pressure remains high and effects of high blood pressure on other body parts like heart, kidneys and brain are commonly seen.

5. Heart has to keep pumping blood to the huge body. It is put to heavy extra work regularly. Therefore, angina, heart attack and heart failure is inevitable even at early stage.

6. Diabetes Mellitus is commonly associated with obesity. Control of diabetes with medicines or insulin requires very heavy doses, even then remains uncontrolled. Uncontrolled diabetes is a nuisance and effects adversely to all body parts.

7. Effects on kidneys due to obesity, added up with hypertension and diabetes leads to chronic kidney disease ending up in failure to dialysis and kidney transplantation.

8. Bones, Joints and muscles always has to carry heavy overweight. They loose their shape and strength. Movements becomes more and more restricted adding to the problems of morbid obesity.

9. Gall Bladder Stone, Liver Disease, Sleep Apnea and Insomnia are some associated problems.

10. Infertility in males and females because of obesity is known. It is quite distressing and depressing for the couple.

11. Dermatitis - bacterial and/or fungal origin are problems in parts, where layers rub each other and not kept hygienically clean.

12. Morbid Obese patients struggles during its life time and with shortening life span marches to the early end.

IF YOU HAVE TENDENCY FOR OBESITY you must consult your doctor. After thorough examinations and investigations root cause of the problem should be ascertained. Accordingly, patient must stick to the advices, medicines or other measures advised by the doctor.

Even after controls, patient may not be able to get rid of fat layers. He should consider surgical options to shed out extra hanging fat layers.

SURGICAL OPTIONS are like lipectomies, abdominoplasty, tummy tuck and LIPOSUCTION. Bariatric Surgery includes gastric banding, gastric bypass procedures aiming to reduce intake. These are mainly for compulsive eaters. Others who are now mentally prepared to reduce and understands the complications of ongoing obesity, wants to get rid of extra fat layers should undergo above listed suitable operations.

LIPECTOMIES means excision of fat layer along with overlying skin. This cut-to-size operation is to remove hanging extra from any part, namely : arms, thighs, chest and any other required area. In belly area term "ABDOMINOPLASTY" is used to cut out extra hanging fat apron plus few associated procedures. 'LIPOSUCTION' is to suck out fat with machine from those areas where 'lipectomy' is not cosmetically indicated. Since need for every patient is different, surgical technique has to be tailored by the COSMETIC SURGEON who has to be an experienced trained and well versed with the meticulous follow up steps along with his trained staff.

HOSPITALIZTION is usually 12-15 days. Patient is ambulatory on 3rd day of surgery. Next 2 weeks are advised to remain restful.

MESSAGE FOR PATIENTS : Every one should know that obesity is a curse. One should not entrapped into it. If signs of obesity has stared showing, please try to get controlled may be with the help of the doctor. Obesity should not be allowed to become "MORBID OBESITY". At any stage, patient should not give up or lost hope. We the doctors, can manage the problem may be in a complicated stage [ within limitations]. Family members and friends must stand along with such patients in full support and help them in overcoming the problem of obesity.

It is equally important to know that obesity is just not the outcome of overeating, there are many more reasons for it. Instead of adding to the mental agony of the patients by saying "Do Not EAT" or "You are always eating" while actually he/she is not; you must try to find the cause and them help in treatment. Patient will be thankful to you.