In the case of morbid obesity (when the body weight is high enough to pose a severe risk to health), for which doctors recommend bariatric (weight-loss) surgery as the most effective long-term treatment.
Obesity is known to increase the likelihood of various diseases, particularly heart disease, type 2 diabetes and breathing difficulties during sleep.
While dieting and physical exercise are the mainstays of treatment for obesity, many studies conducted abroad reveal that the success ratio of the two combined is minimal, underlining that the long-term effects of dieting, exercise and even medical therapy on obesity are relatively poor.
Particularly so in the case of morbid obesity (when the body weight is high enough to pose a severe risk to health), for which doctors recommend bariatric (weight-loss) surgery as the most effective long-term treatment.
Says Dr Kenneth D’cruz, senior consultant and head, department of surgical gastroenterology, Narayana Hrudayalaya Multispecialty Hospital: “While such studies haven’t been published in India, many studies conducted abroad show that less than 20% of people with morbid obesity were able to maintain their weight over a long period of time (around 15 years) with regular exercise for two hours and a strict diet regime. For the rest, the studies quoted a mere 3% success ratio, as compared to a 97% success rate in case of bariatric surgery.”
Recent evidence also shows that bariatric surgery for severe obesity also reduces one’s chances of death due to obesity. Nevertheless, some serious complications could occur and, therefore, it is imperative to carefully screen patients before operating.
“Bariatric surgeons here follow guidelines mentioned by the Asian Bariatric Society for selection of the patients. People with a Body mass index (BMI) above 37.5 kg/m2 with no other associated diseases, or a BMI of 33 kg/m2 and above with diseases like type 2 diabetes, high cholesterol, blood pressure or sleep apnea, are eligible for weight loss surgery,” says Dr Rajshekhar Nayak, a minimum invasive surgery specialist at Gunasheela Nursing Home.
Typically, patients opt for bariatric surgery after trying out numerous solutions offered at various slimming centres. “First, we advise patients to undergo a medically supervised weight reduction programme comprising of dieting, anti-obesity drugs and exercise,” says Dr Nayak, “But the issue with a weight-loss programme is that it requires willpower and perseverance, therefore, it demands 100% commitment. Whereas in the case of weight-loss surgery, the operation takes care of 80% of the job.”
While a patient who undergoes bariatric surgery is also advised to follow an exercise regime of 25 minutes five days a week, according to Dr Nayak patients are unlikely to pile on the kilos even if they skip the exercise.
A pilot study conducted recently suggests that 11 out of 13 patients with type 2 diabetes, who underwent bariatric surgery, had a reversal of diabetes. “Bariatric surgery didn’t help control their blood sugar level, but came as a cure. Results were seen within two weeks to three months post-surgery,” says Dr Nayak.
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