Fat Nation: Rising Obesity Surgeries In the Land of Starvation

Weight loss surgery is booming in India. With 1/5th Indians fighting the fat, here’s all about bariatric surgery

One -third of the world’s population is obese. India is just behind US, Mexico and China in the global hazard list of top 10 countries with the highest number of obese people (Photo: iStock)

November 26th is the Anti-Obesity Day - an international day to raise awareness around obesity as a public health hazard.

Watch That Weight:

• Indian: 30 million people are battling obesity
  
• India: Just behind US, Mexico and China in the global hazard list of top 10 countries with the highest number of obese people.
• India: 18,000 bariatric surgeries carried out in 2014, up from 1000 in 2009.
• Bariatric surgery is a complex operation, 1 in 400 cases are fatal.

With nearly 30 million obese Indians, bariatric surgery is growing at 10% annually.

There is a problem in India and a rather heavy one. With 270 million people living below the poverty line, till about a decade back, obesity was a distant First World issue.

Currently, India is under siege: economic prosperity, massive change in food habits and lifestyle, have led to a wrong kind of growth. Today, 1 in every 5 Indian men and women are either overweight or obese, according to the medical journal The Lancet.

With 30 million Indians battling the bulge, stomach stapling, or bariatric surgery is becoming increasingly common in the country. In 2014, more than 18,000 weight-loss surgeries were counted in the country, up from 1000 just five years ago.

So should everyone with the weight problem go for a surgery? Is it a quick fix to rescue your failing health?

When Is Bariatric Surgery a Necessity?

Bariatric surgery is a laparoscopic or a keyhole surgery done through four small incisions in the abdomen (Photo: The Quint)

Obesity is a bigger problem in India than malaria or tuberculosis. America had this rising curve of obesity in the ’70s. That is where we are today in India.
–Dr Anoop Misra, Chairman, National Diabetes, Obesity & Cholesterol Foundation

Obese Indians don’t look half as huge as their Western counterparts, but we have much more fat than muscle at the same body mass index. Genetically we are designed to live with lesser calories than the developed nation. Over centuries we were under-nourished and now with the sudden exposure of calorie dense food, obesity is spiraling out of control in India.

With 30 to 40% of urban India either overweight or super-sized, we are faced with a crippling double burden of obesity and diabetes. There are 65 million diabetics in the country, 80% of those are caused by obesity.

Bariatric surgery is a radical and risky move, where the doctor pierces through several layers of fats and tissues to open the stomach and cuts it down by almost 85%.

This should be seen as a last resort for people heavier by 25-30kgs than their ideal weight or with a body mass index ratio of 33 and above. People with uncontrollable type-2 diabetes, hypertension or sleep apnea linked to obesity are also likely candidates for the surgery.

Bariatric surgery has been advertised as a cosmetic problem but obesity causes a metabolic storm inside you. It shortens your life, causes very high levels of diabetes and other hormonal changes. This surgery actually saves lives when it is a necessity.

<b>Dr Shashank Shah, Bariatric Surgeon, President of Obesity Surgery Society Of India</b>

Surgery should be the last resort for people with obesity related health problems (Photo: iStock) 

Data from the registered bariatric surgeries done in Delhi from 2006-09 shows that it helped in diabetes control in nearly 88% people, lowered hypertension in 58% and gave increased heart protection (by lowering triglycerides/ LDL) in 82% cases.

Possible Complications

It might sound like a dream to go to a weight loss center and drop all your excess weight in 3-4 days but bariatric surgery is anything but your fantasy. Even if there are no major complications, you will never have the Cinderella ending you dreamed of.

A month after the bariatric surgery, if you have a balanced lifestyle, you lose 6-8 kgs a month (Photo: iStock)

The surgery requires a hospital stay for 3-4 days and can cost anywhere between Rs 2 to 3 lakhs, even upwards, depending on the type of hospital.

After surgery, since your stomach has shrunk to the size of an egg, you will never be able to eat the same way again. And if you do, the weight will be back with a vengeance leaving you sick.

According to a study published in the medical journal JAMA, 1 in 3 patients regain significant amounts of weight a few years after the bariatric surgery. The problem is that over the years, the body begins to adapt to the changes, the stomach stretches and patients can eat more at one sitting and they feel hungrier more often.

If you are the right candidate for a bariatric surgery, chose your doctor and hospital very carefully.

<b>Just like gyms and yoga centres are mushrooming all over the city, 80% of the bariatric surgeons working in small towns are working without an adequate infrastructure and support programs, and that raises the risk of post-surgery complications.</b>

<b>Dr Anoop Misra, Chairman, National Diabetes, Obesity &amp; Cholesterol Foundation</b>

1 in 400 cases can be fatal.