EXPERT OPINION: "The Irish Obesity Epidemic" interview with Dr. Patrick Treacy

The Obesity Epidemic According to SLÁN 2007, in relation to body weight, 39% of those (ages 18+) were medically overweight with a further 25% classified as obese. The most startling part about these statistics is that they show that obesity has almost doubled on the island of Ireland over the past decade. If the current rising trends in obesity continue unabated, associated diseases such as diabetes, heart disease and cancer threaten to overwhelm the health system. In view of these worrying trends, The Irish Medical News decided to interview Dr. Patrick Treacy, Medical Director of the Ailesbury Clinics about the different medical and surgical options available on the Irish market to manage obesity. We shall look at the medical options including weight loss tablets, and newer forms of therapeutic ultrasound, such as Ultrasonic Lipolysis or Ultrasonic Assisted Liposelection. We shall also look at the more interventional methods such as Gastric Banding or Bypass procedures. We will evaluate which method should be used in differing circumstances. IMN What exactly is obesity and is it true there are different types? Dr PJT Obesity is a condition in which excess body fat has accumulated to such an extent that health may be negatively affected. It is commonly defined as a body mass index of 30 or higher. This distinguishes it from being overweight as defined by a BMI of between 25–29.9. Excessive body weight is associated with various diseases, particularly cardiovascular diseases, diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritis. As a result, obesity has been found to reduce life expectancy. The primary treatment for obesity is dieting and physical exercise. If this fails, anti-obesity drugs, liposuction and (in severe cases) bariatric surgery can be tried. IMN How prevalent is Obesity in Ireland and are you concerned? Dr PJT Obesity now affects 23% of people in Ireland, according to Government statistics. Notwithstanding this, a further 42% of citizens are overweight. If the current rising trends in obesity continue unabated, associated diseases such as diabetes, heart disease and cancer threaten to overwhelm the health system. IMN Would you prescribe weight loss tablets and how do they work? Dr PJT Yes, I do. I presently use Reductil and Xenical capsules. Reductil contains the active ingredient sibutramine, which works by affecting neurotransmitters in the brain. Reductil is only licensed to aid weight loss in people with a body mass index (BMI) of 30 or higher, and people with a BMI of 27 or higher who also have other obesity related risk factors, (type 2 diabetes or high cholesterol). IMN Can you tell us about Ultrasonic Contouring? Dr PJT This is a surgery-free body contouring treatment to successfully remove fat cells using ultrasound technology for effective and visible results. It is suitable for removing unwanted fat from the abdomen, inner and outer thighs and flanks. IMN How does it work? Dr PJT This method uses high energy focused ultrasound technology to remove unwanted fat. An ultrasound beam selectively targets fat cells in the chosen body region, and disrupts them without harming surrounding nerves, blood vessels or skin. IMN What happens to the fat cells? Dr PJT During the treatment the fat cell membranes are disrupted and dispersed into the fluid between the cells before being transported through the vascular and lymphatic systems to the liver. It is cleared from the liver via the body's natural mechanisms. IMN How many treatments are required? Dr PJT It is now recommended that a patient should get 3 treatments. You can expect to loose up to 2.5cm in body circumference per treatment. At present, we are able to treat the abdomen, inner and outer thighs (saddle bags) and flanks (love handles). MN What about Laser lipolysis. What exactly is it? Dr PJT Laser lipolysis uses a fine cannula to deliver a safe, powerful laser to heat the fat cells, causing them to break down. It is performed under a local anesthetic and is proving to be a very popular treatment with less downtime and side-effects than traditional liposuction. The fat deposits are thought to be absorbed and pass out of the body, naturally. It is generally used to remove about 500-600mls of fat. . IMN What body regions can be treated with Laser lipolysis? Dr PJT Laser lipolysis is ideal for treating small areas of the face, neck, arms, breasts (gynaecomastia), and areas of loose and flabby skin (floppy skin). It can be an adjunct to traditional liposuction procedures. IMN Are there any side effects with Laser lipolysis? Dr PJT Minor bruising or discomfort may occur in the short term. Results can be seen as soon as a week with continued improvement over several months. s IMN What is Ultrasonic assisted liposelection? Dr PJT Ultrasonic assisted liposelection is a new and very different way to precisely and efficiently remove unwanted fat. It is an alternative to the harsh techniques of traditional liposuction; this method uses state-of-the-art ultrasound technology to break up fat while leaving surrounding tissue - such as nerves, blood vessels, and connective tissue - relatively intact. IMN How does Ultrasonic assisted liposelection work? Dr PJT The device emits high frequency sound energy to break up fat on contact while leaving surrounding tissues relatively intact. The fragmented fat flows into the wetting solution and is extracted through suction and massage. This process results in smooth, predictable outcomes. IMN What Is Liposuction and is it still used? IMT Absolutely, liposuction, also known as lipoplasty is a procedure used to remove unwanted localised fat deposits from certain areas of the body, including the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck. It is an older technique, often requiring general anaesthetic and does not impart energy to lead to skin tightening IMN Who is a good candidate for Liposuction? Dr PJT It goes without saying that patients should be in good health. This is important as many fat patients have concurrent illness such as diabetes and heart disease, making them at risk to anaesthesia and infections. A perfect patient should also have good skin elasticity and localised pockets of fat. IMN Are there any risks associated with Liposuction? Dr PJT Liposuction carries a small but important mortality risk. Recent studies indicate rates of approximately 1 per 5,000, with lung clots pulmonary and fluid imbalances the major causes of the problem. The tumescent technique for liposuction is still considered the safest form of liposuction. IMN Can you tell us something about the Gastric Band procedure? Dr PJT There are various types of gastric band but all involve placing a hollow adjustable gastric band around the upper part of the stomach to divide it into a small upper pouch above the band and a larger pouch below the band. The small pouch limits the amount of food that a patient can eat at any one time and will result in a feeling of fullness after eating a small amount of food. H&L What is the Easyband (TABG)? Dr PJT The Easyband (TAGB) uses sophisticated electronics to close or open the gastric band without the need for an access port of any kind. The gastric band surgery procedure itself takes 30-45 minutes, on average. Assuming things go well, you will be in hospital overnight after your lap band surgery, and discharged the following day. Gastric banding in good hands is not a high-risk procedure. IMN What about gastric bypass? Dr PJT Gastric bypass surgery is a form of weight reduction surgery that is more extensive than gastric banding, and therefore tends to be better suited to patients who have more weight to lose. There are several types of gastric bypass, but all involve the creation of a small stomach pouch to restrict food intake and surgery to bypass the duodenum and small intestine to cause malabsorption


# # #

Ailesbury Clinics Ltd is the leading provider of advanced medical aesthetic skin care in Ireland. It was awarded Best Medical Practice in Ireland 2005. Further details WEBSITE http://www.ailesburyclinic.ie PHONE +3531 2692255/ 2133 Fax 2692250

Name*:
E-mail*:
Captcha*:
Text*: