Do away with that flab

Bariatric surgery is an option for people dealing with obesity

Bariatric surgery is in the news once again because of 23-year-old S Rajasekar from Chennai. The youngster who weighed 200 kgs before laproscopic sleeve gastrectomy, a form of bariatric surgery where 85 per cent of the stomach is removed, died a few days after the surgery despite responding well.

Doctors said it could have been pre- surgery complications that caused his death. Even as more people in the city are showing keen interest in bariatric surgery and are going under the knife for a healthier tomorrow, DNA speaks to experts to get a low down on the procedure and its possible risks.

High Demand in Bangalore: City based gastroenterologists say that at least eight to 10 people from the city undergoes bariatric surgery every month. Most cases however are not for cosmetic reasons. The goals of these procedures are often weight loss, improvement of hypertension, resolution/ significant improvement in diabetes (Type 2), improvement in arthritis and resolution of sleep apnea among the many benefits.

“A better appearance is a bonus and not the primary goal of doing this procedure. Bariatric surgery is not a shoppers’ stop for every patient suffering from obesity,” says
Dr Srikanth, consultant surgical gastroenterology of Manipal Hospital.

In India, there are limited centres in Delhi, Mumbai, Chennai, Hyderabad and Bangalore where bariatric surgery is performed.

“Bangalore, known for its medi tourism, is attracting lots of international patients for bariatric surgery. Foreigners prefer Bangalore, as in the west, the approximate cost of this surgery is around $36,000, while they can get it done within $8,000 and $10,000 within the city,” says Dr Saurabh Mishra, gastroenterologist and bariatric surgeon, New Apollo Hospital.

What the surgery entails?
Doctors say that bariatric surgery doesn’t mean a 100 per cent excess weight reduction. “There can be a loss of 85 per cent of the excess weight through bariatric surgery. However, around 50 per cent of that 85 per cent excess weight is lost within the first 5 to 6 months of the surgery and remaining 50 per cent takes another 1 to 2 years to reduce,” said Dr Srikanth,

There are two types of bariatric procedures commonly performed: Laparoscopic adjustable gastric band and Laparoscopic gastric bypass procedure. As both these procedures are now done through key-hole surgery, it typically requires hospitalisation of three to four days. However, it takes around 15 days for the patient to get accustomed with the new lifestyle post surgery and to get back to the normal life.

What are the possible risks?
Although recommended by doctors for those with Body Mass Index (BMI) of over 35, this surgery has sometimes been considered risky even though it produces results and has been known to help those with morbid obesity and those with life threatening conditions. “Any surgery done on obese people involves certain risks. Obese people suffer from hypertension and diabetes and their morphology is different. They are more susceptible to infection,” says Dr Misra.

Also, there’s a possibility that the patient may gain weight again. Post Operative care is crucial. Due to the sudden weight loss post bariatric surgery, the patient tends to feel week and make minimum movements. This leads to clot formation in the leg that travels up to the brain and chest causing sudden death, explains the doctor. “Thus enough time should be given to the patients before the surgery, educating them about the lifestyle modifications and diet regimes. They need to keep their body hydrated all the time, adds Dr Misra.

Bariatric surgery requires both time and effort from the patient to achieve the desired results, he says. “Patients need to follow the dietary regime as advised by the dietician, apart from physical activities like at least 45 minutes of walking, some gymming or aerobics,” says Dr Srikanth.