Brief Answer: Diet is the mainstay / detailed discussion below Detailed Answer: Dear Mr XXXXXXX Welcome to Health Care Magic Your sleepiness may be from Sleep Apnoea Syndrome – respiratory depression causing disturbed sleep in the night and leading to day time somnolence, in obese people. Consultation and investigation by a Pulmonologist is necessary to clarify the issue _________________________________________________ Weight is like bank account / The amount in your account comes down when you withdraw more (physical work) and you deposit less (eat less). If the weight is picking up, it only means – the exercise is not enough / the food is more / or both.... _______________________________________________________ Obviously, you cannot do exercise because of your knee problem, which also could be from excess weight… Exercise helps, but its role however is limited. For example, in walking 1 kilometre, one spends 1 Calorie per kilogram of his body weight! A cup of rice or an average bar of chocolate has approximately 200 calories. A treadmill may help. The ideal solution is to consult an Orthopaedician and follow up by a Physiotherapist - they can help to restart an exercises program, tailored to you. __________________________________________________________ Diet is the mainstay of treatment. You have to reduce the QUANTITY of your food and change the QUALITY too. It is not possible to explain or understand the nuances on a single occasion. To start with, reduce the amount to one third of what you are presently taking. Avoid all fats – they have double the energy of carbohydrates. You should see a good DIETICIAN - One generally needs SEVERAL sessions, to master concepts of calories, nutritional values, biological value, vitamins, minerals and so on. ________________________________________________________ It needs strong motivation / many are helped by psychological assessment and assistance For weight reduction, there is no officially approved medicine without serious side effects. The only other alternative is Bariatric surgery The treating doctor can suggest further based on his assessment of the situation. Good luck Take care Wishing all well God bless

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Brief Answer: Life style changes must and first Detailed Answer: Dear friend, Life style changes are the corner stone of treatment. Aggressive management of all the risk factors is the cornerstone of management. They are necessary now and after any intervention too Surgery is only an incidence in the course of management; it is not curative straightaway / it can have its own risks and complications / it should never be the first choice… It is not covered by Mediclaim in most places / I have no idea of the cost – it varies with the place, comorbidity and so on…it is not cheap. The treating doctor alone can suggest further, based on his assessment of the situation. Regards

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