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.