Gobar Times
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Slim Chance

So you can’t stop eating chocolates and exercise is not really your thing. But you still want to look like Kareena Kapoor? You are not alone. Frustrated, people are lining up at Bariatric surgeons’ clinics for quick but drastic measures which involve, among other things, cutting up your stomach and removing large chunks of it. (Did you just yell Y.U.C.K?)

Medical practitioners may impose strict guidelines on who can proceed with such surgeries but this hasn't stopped people without morbid obesity from approaching them. According to Dr Rahul Manchanda, a Gynae Endoscopic surgeon from the Manchanda's Endoscopic Center, who tackles cases of obese women, Bariatric or obesity surgeries are being performed left, right and centre when “it should be used only as a last resort – when there is a possibility of death.”

Surgery among not-so-obese people is common. On an average, 5-8 people approach Dr Abhay Agrawal of the Centre for Obesity Control daily. Not so long ago, liposuction used to be the flavour of the season. It involved creating small suctions with a tool called cannula in the area between the skin and muscle and injecting excess fat out of the body. It promised to improve the shape of one’s body but cases of bruising, scarring, were reported.

Now, Bariatric surgery, a more “permanent” option has taken over. Liposuction, after all, had to be repeated periodically. Complicated procedures like Roux en Y Gastric Bypass are purportedly effective for a period of 14 years. Also, as Dr Sunil Choudhary, plastic surgeon, Max Aesthetics Centre, points put, if you are morbidly obese, bariatric surgery is a good option because liposuction can reduce very little weight.

Here are some of the bariatric procedures performed in India:

1. Intragastric Balloon:

A non-surgical option, this one is for mild to moderately obese patients. It involves the introduction of a balloon in the stomach (inserted through the mouth) which will fills up space and reduces food intake. Advantage: Since you are not overeating, your body is forced to dip into its own fat for energy. Repercussions: Nausea, bowel obstruction, balloon may deflate.

2. 'The Lap Band' (Laparoscopic Gastric band)

Surgeons create a small stomach by restricting the original stomach with an adjustable silicon band. The small stomach has a narrow opening which means that food takes longer to reach the intestine. Hence, a person is satisfied with smaller meals for a longer duration.

Advantage: Surgery is reversible.
Repercussions: Vomiting, hernia, infections in the incisions points, band slippage, bowel obstruction, ulcer.

3. Laparoscopic Gastric Bypass Surgery (Roux en Y)

Doctors create a small upper stomach pouch with a stapler which also means reduced food intake. In addition, food also skips a large part of the stomach and small intestine, resulting in less absorption of calories and nutrients.

Advantages: Surgeons claim that even after 14 years, the body will lose 65 to 80 per cent of its excess weight
Repercussions: Nausea, diarrhoea, nutritional deficiencies, hernia, gallstones.

4. Laparoscopic Sleeve Gastrectomy

Patients lose about 2/3 of their stomach. This includes the hunger stimulating hormone. The stomach is stapled and reduced to the size of a banana or a sleeve, hence the name. It is simpler than bypassing parts of the stomach.

Advantages: Scientists promise 90-98 per cent improvement in obesity-related diseases as well as the quality of life.
Repercussions: Infections in the incisions points, ulcer, respiratory problems, blood clots in lungs, staple may come apart causing leakages.

For faster recovery, surgeons prefer the laparoscopic (or keyhole) approach – Surgical tools are inserted through small incisions along with a camera which allows doctors to conduct operations without opening the body.

Should you go in for surgery?

Age, weight, diet, medical condition, cause of weight gain etc. determine which procedure suits which patient. According to Agrawal, the most common procedure is Sleeve and Bypass. He informs us that the whole pattern of diet and behaviour changes after surgery. “Patients need a lot of follow up and counselling.”

Calculate your Body Mass Index

BMI = Weight (kgs)
height (m)2

According to surgeons, if your BMI is 35 or above and you have the obesity-related diseases listed above, surgery might be a good idea. It is still in your interest, they say, if you don't have any of the associated diseases but your BMI is above 40.

On a weight loss trip: An obesity surgery in India costs 30 per cent to 70 per cent less as compared to the US and the UK. Mumbai, New Delhi, Bengaluru and Chennai are some of the cities to which these medical tourists are converging.

Now locate yourself in the table given below*

But Anusha Chandrasekaran, who works for an NGO, is not swayed by figures. She says: “Stop … (when we start telling her about Sleeve Gatrectomy) Don't even tell me about them. It is so gross. I will never go for one of these surgeries.”

Bariatric surgery: What is that?

Obesity is said to be the second most deadly disease of the 21st century. Surgeons claim that their procedures have resulted in significant improvements in associated diseases like hypertension, diabetes, heart and joint problems, sleep apnoea and depression. Dr Vandana Soni (Senior Consultant, Minimal Access, Metabolic & Bariatric Surgery, Max Healthcare) says, “Bariatric surgery offers a ray of hope for patients suffering from severe weight gain (who want) to lose weight and lead a normal life. It has also shown to resolve metabolic diseases like diabetes and hypertension.”

But there are many horror stories on the internet about surgeries gone wrong including near death experiences.