Bariatric Surgery

“Having too much of anything is not always Good”

Bariatric Surgery in India (Obesity / Weight Loss Surgery in India )

Overview-

Bariatric Surgery is a procedure performed on people who are dangerously obese, for the purpose of losing weight. This surgery is performed on the stomach and intestines causing a reduction in the patient’s food intake. It changes the anatomy of your digestive system to limit the amount of food you can eat and digest. Results from this obesity surgery are –significant long-term weight loss, recovery from diabetes, improvement in cardiovascular risk factors, and a reduction in mortality and morbidity.

Although Bariatric surgery requires only a few days of hospital stay, it is a permanent procedure that requires a lifetime commitment to maintain a healthy lifestyle. Benefits of bariatric surgery are not limited to weight loss, but can help improve your overall health, well-being and self-esteem. The National Institutes of Health (USA) recommends  bariatric surgery for obese people with a BMI of at least 40, and for people with BMI 35 with serious coexisting medical conditions such as diabetes.

Bariatric surgery is an excellent alternative for people who have not been able to lose significant weight through exercise and dieting and whose general health is compromised.

OBESITY and MORBID OBESITY

What Is Obesity?

A life-long, progressive, life-threatening, costly, genetically-related, multi-factorial disease of excess fat storage with multiple co-morbidities. Obesity is a term used to describe body weight that is much greater than what is healthy. If you are obese you have a much higher amount of body fat than in healthy or desirable.

How to measure obesity?

Measure of Weight Status

BMI (Body Mass Index) = Weight in Kg/(Height in Meters)2

  • Adults with a body mass index (BMI, calculated as weight in kilograms divided by height in m sq) between 25 kg/m2 & 30kg/m2 are considered as overweight.
  • Adults with a BMI greater than or equal to 30 kg/m2 are considered obese.

What Is Morbid Obesity

  • Clinically severe obesity at which point serious medical conditions occurs.  Anyone who has a BMI greater than or equal to 40kg/m2 or  BMI 35 with serious coexisting medical conditions such as diabetes is considered morbidly obese. For Indian patients the recommended values are 32.5 and 37.5 instead of 35 and 40 respectively. Morbid obesity is the new epidemic that is slowly engulfing our country with changes in eating habits and lack of exercise and physical activity the disease is becoming more prevalent, especially in cities.
  • 20-25% people in India are overweight, of which 7-9% are morbidly obese which amounts to a staggering 2 – 2.5 million people. Incidence of child hood obesity is on the rise due to changing lifestyles. These people are more likely to develop obesity related complications at an earlier age. If not addressed today this problem is likely to compound, imposing heavily on medical resources

Obesity–

Obesity can have varying health effects on men, women, teens, and children. But it affects each group-

Obese Children–

The fastest growing segment of the obese population is our youth. Obesity in children has increased by over 30 percent over the last 10 years, with a staggering 19 percent of children from 6 to 19 years old now categorized as obese.

  • Health Risks:

    Obese children face serious health risks. They are at a dramatically higher risk for type 2 diabetes than their peers, and recent studies have shown that inactivity prevents obese children from proper neurological development. They are also more likely to remain obese for the rest of their life, leading to more serious obesity-related health problems.

  • Causes:

    Obese children are often victims of aggressive advertising for junk food and soda products. Poor family nutrition and exercise habits can also be blamed for the recent influx of childhood obesity. Because fat cells are so easy to create but so difficult to lose, obese children typically grow up to be obese men and women.

  • Children and Bariatric Surgery:

    For obese children, weight loss surgery is not an option. It is therefore essential that sensible diet and exercise routines are established as early as possible, and that the entire family embraces a new, healthier lifestyle.

Obese Teenagers–

Obese teenagers often experience health and social problems as a result of their weight. Learn about the health problems associated with teenagers who suffer from obesity, as well as the weight loss options available to teens.

  • Health Problems:

    Obese teens have a heightened risk of developing serious and life-threatening conditions, including type II diabetes, asthma, and other medical issues that are common in obese adults.

  • Social Effects:

    Depression is especially common among obese teens, who are often subjected to shame and social isolation by their peers. Many obese teens also become depressed because the intense media exposure most teenagers are subjected to causes them to have distorted self-images and unrealistic expectations of their bodies.

  • Restrictive Diets:

    It is unrealistic to expect obese teens to lose weight with the same diet and exercise routines that work for obese men and women. Restrictive diets are most often ineffective with obese teens, partially because teenagers are rebellious by nature and also because so much of teen culture revolves around fast food, soda, and junk food. In fact, teens on restrictive diets usually gain weight long-term.

  • Lifestyle Changes:

    A more effective weight loss approach for obese teens, then, is a change of lifestyle. Obese teens need to be educated on how to make wise food choices while still being able to enjoy the typical teen lifestyle. Teenagers who are obese should also be encouraged to engage in and enjoy physical activities. For obese teens and obese children, it is essential that the entire family works together to implement healthy lifestyle changes. Obese teens should meet with an experienced physician to discuss the best approach to weight loss, whether it involves weight loss surgery, or a stricter diet and exercise regimen.

  • Bariatric Surgery:

    Many surgeons believe that teenagers lack the maturity necessary to make an informed healthcare decision, such as the decision to undergo complicated weight loss surgery. However, in some life-or-death cases, obese teens have successfully undergone bariatric surgery. While  surgeons are now performing weight loss surgery on obese teens, the long-term safety and effectiveness of these procedures is yet to be determined.

Obese Women –

The prevalence of obese women is almost double that of obese men. Studies have shown that more than one-third of  women are currently obese. obese women are more commonly members of a minority and of a lower socio-economic status, and middle-aged women are at the highest risk of becoming obese.

  • Social Effects:

    Obese women are often the victims of depression. In a society that stresses the beauty of slenderness, women who are obese face substantial social discrimination, even more than obese men. Obese women also face employment and workplace discrimination. In fact, a recent study shows that formerly obese women who underwent weight loss surgery saw a drop in unemployment from 84 to 64 percent.

Obese Men –

It is extremely important that we be aware of the health effects associated with male obesity, as well as the treatment options available for obese adults.

  • Social Effects:

    Like obese teens and women, obese men are likely to suffer from depression and discrimination from peers.

You can Beat Obesity !

Yes, obesity can be treated. But it involves more than just swallowing or sticking to a diet. It needs a multidisciplinary assessment that sees several different specialists working together ;

Dietician, Endocrinologist, Psychologist, Physiotherapist ,Internist, Cardiologist, Family doctor  and most important Bariatric surgeon.

Treatment  is tailored to meet the needs of each individual case-

  • Psychological support
  • Diet and behavioral therapy
  • Pharmacotherapy.
  • Obesity surgery

If you are morbidly obese and have tried other treatments without success, you might explore the obesity surgery. Bariatric surgery combined with behavioral and dietary modifications, is currently the only proven method of achieving long term weight loss for the morbidly obese.

Obesity Surgery-a solution worth considering !

  • You are eligible for obesity surgery if
  • Your BMI is 40 or above.
  • Your BMI is 35 or above and you have obesity- related health conditions (co-morbidities)

Bariatric surgery or weight loss surgery includes a variety of procedures performed   on morbidly obese people. Weight loss is achieved by reducing the size of the stomach with an implanted medical device ( Gastric Banding) or through removal of a portion of the stomach (sleeve gastrectomy or biliopancreatic diversion with duodenal switch) or by resecting & re-routing the small intestine to a small stomach pouch (Gastric Bypass Surgery).

However Bariatric Surgery is a costly procedure . The average cost of the commonly done procedure ranges between 2.5 to 5 lakh Indian rupees or 5,000 to 12,000 US Dollars depending upon the type of procedure performed

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