According to Union health ministry of India (Dec 2008 Guidelines):

• Normal Weight: Body Mass Index (BMI) of 18.5 – 22.9 Kg/m2
• Overweight: Body Mass Index (BMI) of 23 – 24.9 Kg/m2
• Obese: Body Mass Index (BMI) of 25 or more

An Indian needs drug therapy if BMI is 25 kg/m2 or more.
An Indian qualifies for bariatric surgery if BMI is 32.5 kg/m2 as opposed to the international standard of 35 kg/m2

According to World health Organization/International Standard:

• Normal Weight: Body Mass Index (BMI) of 18.5 – 24.9 Kg/m2
• Overweight: Body Mass Index (BMI) of 25 – 29.9 Kg/m2
• Obese: Body Mass Index (BMI) of 30 or more
• Morbid Obese: BMI of 40 or more (roughly, 45 kg more than your ideal weight)

Obesity could be a combination of the following:

• The genes you inherited from your parents
• How well your body turns food into energy
• Your eating and exercising habits
• Your surroundings
• Psychological factor

• Shorter Life Expectancy
• Compared to people of normal weight, obese people have a 50% to 100% increased risk of dying prematurely
• Obese people have more risk for:
  • Diabetes (type 2)
  • Joint problems (e.g., arthritis)
  • High blood pressure
  • Heart disease
  • Gallbladder problems
  • Certain types of cancer (breast, uterine, colon)
  • Digestive disorders (e.g., gastroesophageal reflux disease, or GORD)
  • Breathing difficulties (e.g., sleep apnea, asthma)
  • Psychological problems such as depression
  • Problems with fertility and pregnancy
  • Urinary Incontinence

• Negative self-image
• Social isolation
• Discrimination

• Normal tasks become harder when you are obese, as movement is more difficult
• You tend to tire more quickly and you find yourself short of breath
• Public transport seats, telephone booths, and cars may be too small for you
• You may find it difficult to maintain personal hygiene

After extensive research it has been concluded that, Surgical Treatment is the only proven method of achieving long term weight control for the morbidly obese, when all other therapies have failed. Only 5 Obese maintain weight loss with diet and exercise out of 100.

Plastic surgery can effectively reduce weight to very less extent with no guaranty of maintained weight loss. There is no reduction in the status of co-morbities. Bariatric Surgery gives a Guaranteed and maintained weight loss with resolution of various co-morbities like Diabetes, Hypertension, Arthritis etc

Bariatric Surgery is possible as both open as well as with Laparoscopic Approach. The Laparoscopic approach has given excellent results.

Most common cause is congenital. Other factors are strenuous exercises, chronic cough, straining for urination and in passing stools.

There is always a theoretical chance of obstruction or strangulation of the contents of hernial sac, which can be life threatening.

In laparoscopy a bigger mesh is placed as compared to open surgery, which prevents recurrence of hernia. It also covers the other hernial potential defects like femoral openings.