On Monday, Dongri resident Nazir Abdul Ahmad Rehman, 53, left his 100-sq metre tenement for the first time in five years. He underwent a three-hour-long bariatric surgery, which will finally enable him to lead a normal life. Dr Sanjay Borude of Breach Candy hospital, who performed the surgery successfully on Rehman, spoke to DNA on the growing obesity problem in the city.
Borude is the former vice president of Obesity Surgery Society of India and is currently the Asia-Pacific representative, International Federation of Surgery for Obesity.
Rehman, at 190 kilos, has not been able to walk for a long time. Post surgery, how soon will he experience noticeable weight-loss?
He will be able to go for a routine walk six months after the surgery. In six months, he will reduce almost 40 kilograms.
What is the success rate of bariatric surgery?
I have been performing this surgery for the past ten years, and have operated on more than 1,000 patients. I have not seen a single mortality in this procedure. However, there is a risk involved of less than 1%, due to some complication that may occur.
Who is an eligible candidate for obesity surgery?
People with a body mass index (BMI) of more than 37.5 due to weight are eligible for this surgery. I see a lot of female patients who come for this surgery before marriage. I have performed more than 40-50 surgeries on patients of marriageable age and post surgery their lives have changed.
Is childhood obesity on the rise?
In a city like Mumbai, childhood obesity is rising rapidly. My youngest patient is a 14-year-old who weighs 120kg. But after the surgery, he weighs 80-85 kg. Now, after increasing awareness about surgery as an option to lose weight, more and more parents are approaching the hospital with queries. I see a lot of teenagers between 14 and 18 years who are morbidly obese. Some of these children are also diabetic.
How many days of hospital stay is required post surgery? What kind of surgeries are available for obesity?
There are two options available for obesity surgery: Sleeve gastrectomy and gastric bypass. Sleeve gastrectomy is a restrictive form of weight-loss surgery in which approximately 85% of the stomach is removed, leaving a cylindrical or sleeve-shaped stomach. This has a capacity ranging from about 60 to 150cc. The removal of the major part of the stomach results in virtual elimination of ghrelin hormones which stimulate hunger. As the new stomach continues to function normally, there are far fewer restrictions on the food which patients can consume after surgery, though the quantity of food eaten will be considerably reduced.
What kind of tests are done before weight-loss surgery?
Certain basic tests are done prior to surgery: A complete blood count (CBC), urinalysis, and a chemistry panel, which gives a readout of about 20 blood chemistry values. Often a glucose tolerance test is done to evaluate for diabetes, which is very common in overweight persons. All barring the very young will have to get a chest X-ray and an electrocardiogram done. Women may have to go for a vaginal ultrasound to look for abnormalities of the ovaries or uterus.
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