Is weight loss surgery the answer to the increasing incidence of obesity? While losing weight can be a challenge due to the modern lifestyle and its resultant stress, is going under the knife a safe option? There’s no black and white. However, there are many ifs and buts.
In India, the incidence of morbid obesity is five to 10 per cent, which is a big number taking into account the population. What is even more alarming is that childhood and adolescent obesity stands at 10 to 15 per cent, which is not good news for a developing nation like ours.
Clinical evaluations show that one to two per cent people have problems like respiratory infections, blood clots and leakage at surgical sites. these problems need proper monitoring or they could prove to be fatal.
Dr K.S. Lakshmi, a senior bariatric surgeon explains that the surgery is not for all and it is only for those who have to lose more than 30 kilos. Morbid obesity is a situation where obesity-induced diseases like diabetes, hypertension, heart diseases, breathing disorders and cancer are found and it is only for this stage that bariatric surgery is advised. Moreover, those who undergo surgery have to deal with quite a few vitamin and nutrient supplements so that the body does not lose out on its essential constituents.
Under what circumstances do doctors advise bariatric surgery?
Obesity is increasingly becoming a serious issue and is the fifth leading cause of global deaths. At least 2.8 million adults die each year due to obesity. In addition, 44 per cent of diabetes, 23 per cent of ischemic heart disease and between seven to 41 per cent of certain cancers are attributable to being overweight.
Bariatric surgery is a scientifically designed surgery for the stomach and small intestines to bring about significant weight loss. This is generally advised to morbidly obese people whose body mass index (BMI) is above 32, i.e. on people who need to lose at least 30 to 40 kilos of their body weight to get relief from the bad effects and medical problems associated with excess weight.
Who is eligible for this surgery?
The surgery must not be done on patients who have to lose weight lesser that 20 kilos. It is not to be performed on children and very elderly women.
Before opting for bariatric surgery, is the patient advised to try losing weight in any other way?
The fundamental cause of obesity is an energy imbalance between the calories consumed and calories expended. Generally, people across the world have increased the intake of energy-dense foods that are high in fats, salt and sugar but low in vitamins, minerals and other micro-nutrients.
Ideally, an obese patient is advised to cut down the calorie intake by following a healthy diet and increase the body metabolic rate with exercises such as walking, swimming, cycling, gym, yoga, aerobics, dancing and so on. In spite of this, it is found that some people are not able to lose much of their weight. These are the ones who are advised to undergo bariatric surgery.
But after the surgery, there is also a psychological impact on patients as they crave for food and there are some who also feel bad that they can’t eat to their heart’s content?
Once a person becomes morbidly obese, and is unable to get the weight off, there is usually a sense of failure or depression that they suffer from. Further such people depend on food for emotional and psychological support — this in turn adds to their weight gain. Few studies show that people gaining weight have an alteration in their normal intestinal bacteria, which can change the way the body metabolises the food. After the surgery, there are changes in the body, so there is counselling and also regular follow-up to help the patient deal with it.
What is the post-operative care that a person must take?
Post-operative care takes into account a lot of training and working towards eating healthy foods. The patient has to cut down on sweets, fatty and junk foods. Moderate exercise is also recommended.
What are the dangers involved and what can go wrong in the process?
No dangerous situation can arise just because of surgery. Mishaps happen if the patient has been neglecting his/her body and most organs are damaged due to their weight. Surgeons have to check these aspects and there has to be an emergency team ready to deal with any untoward incidents. The outcome of bariatric surgery has mostly been good.