Obesity and Metabolic Surgery: Hype or Hope
Bariatric surgery is one of the most popular surgeries, which helps obese people lose weight. It is a procedure that reduces the size of the stomach with a gastric band or removes a portion of the stomach that results in the interruption of the digestive system and therefore, restricts the amount of food a patient can eat.
Sudha (name changed), a 37 year old senior executive in a software firm, was finding it increasingly difficult to cope with the stress of corporate life. She had been physically fit and an athlete during her college days. However, a well paying job, sedentary lifestyle and erratic food habits resulted in a rapid weight gain in ten years and she currently weighs 98 kgs. However, when she was in college she weighed 58 kgs. To make matters worse, she was diagnosed with high blood pressure and diabetes two years before receiving daily medications and making changes to her diet. All efforts to diet seemed to fail. She never saw a real decrease in weight despite several months of exercise. This left her depressed and frustrated. In our daily practice, we come across several people like Sudha.
The human race has physiologically adapted over the years to situations of food scarcity. The last few decades have seen a paradigm shift in food availability resulting in a situation of abundance. This fact, along with increasing physical inactivity, a result of current lifestyle and employment patterns has resulted in a dramatic increase in obesity. More alarming is the steep rise in the number of diabetic patients, those suffering from high blood pressure, heart ailments, sleep disorders, arthritis, depression and infertility. These co-morbid conditions often associated with obesity have resulted in an estimated twelve years decline in life expectancy in this population.
The cornerstone for maintaining an ideal weight are a balanced diet and regular exercise. Diet and exercise alone give good results to the few who are committed and are overweight. However, adequate and long term sustained weight loss are nearly impossible to achieve with these measures alone, particularly when it comes to morbidly obese individuals. Also, the risks posed by co-morbidities among the morbidly obese are considerable. The only proven long term option for satisfactory weight loss and a cure to co-morbid conditions such as diabetes, high blood pressure etc, is metabolic surgery. Although, bariatric/metabolic surgery has been practiced, mostly in the west, there is now a greater acceptance of these procedures in India. This is because of increased awareness. The other reason is the use of minimally invasive approach involved in bariatric/metabolic surgery, which has resulted in quicker recovery and fewer complications. In India, for instance, the number of bariatric surgeries performed in 2003, were less than five hundred and currently, this number has risen to an estimated 10,000 per year.
*Data Courtesy: Dr.G Srikanth, Chief of Gasteroinstinal and Bariatric Surgery, Sahasra Clinic