Eman Ahmed, formerly the world’s heaviest person passed away in Abu Dhabi due to complications caused by the several health issues she was facing. She once weighed 500 kg and had undergone a surgery at Mumbai’s Saifee Hospital.
Her treatment had got the world curious about ‘bariatric’ or weight loss surgery.
She had a subsequent fall out with her medical team in Mumbai and had returned to Abu Dhabi for further treatment.
While Ahmed was left with little options, bariatric surgery is not for everybody. A decision to opt for the surgery has to be carefully evaluated between your doctor and you. Here’s a handy list of pros and cons if you or your relatives are contemplating weight loss surgery.
Let's Talk About the Pros First
1. Metabolic Benefits
Other than the weight loss, the surgery is expected to provide metabolic benefits that improve one’s lifestyle significantly.
In most cases, it normalises blood sugar, reduces hypertension and cures sleep apnea. According to a New York Times report, the surgery may not be able to cure Type 2 diabetes, but it does put it into remission and prevents it from damaging the heart.
2. Improved Chances of Pregnancy
According to a pan-Indian survey conducted by AIIMS and Dr Anoop Misra – a leading Indian endocrinologist – two in three women in metros, and every eighth woman in Indian villages, is overweight or obese.
Infertility, one of the comorbidities of obesity, is expected to improve after the surgery.
It becomes 8-10 times safer to give birth post the surgery. The chances of pregnancy, ovulation, continuation of pregnancies and of a healthy baby are much better.Dr Atul Peters, metabolic surgeon, Fortis Hospital
Since the maximum weight loss takes place in the first 12-18 months of the surgery, doctors recommend waiting at least a year before conceiving, as a pregnancy occurring during a period of malnutrition could lead to complications.
3. Emotional and Psychological Benefits
Those who undergo the surgery come out feeling better and more confident, emotionally and socially. In the first few days of her treatment, Ahmed, who has been confined to her room for nearly two decades, has lost enough weight to blow kisses to her doctors, reports The Indian Express.
Another patient, who weighed 96 kilos before her surgery, said she was happy to tolerate the side-effects as the surgery gave her back her confidence.
4. CGHS Covers the Cost
It is expensive and requires the patient to stay in the hospital for several days. This means the surgery alone can cost anywhere between Rs 2-3 lakh or more, depending on the type of hospital and the follow-up care required for each patient.
Thankfully, the cost of the surgery in cases of ‘morbid obesity’ is covered under the Central Government Health Scheme in government hospitals as well as private hospitals empanelled under the scheme.
Now, Let’s Hear the Cons
1. Malnutrition
A common side-effect of the surgery is malnutrition and vitamin deficiency owing to stark alterations in the digestive system.
A deficiency of key vitamins and nutrients often cause hair loss and damage to the skin and nails. A patient may feel weak and tired for several months post surgery. They may not even be able to keep the food down as the smaller stomach now thinks of the tiniest portions of food as extra.
2. Putting the Weight Back On
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.
According to a study published in the Journal of the American Medical Association, one in three patients regain weight a few years after the bariatric surgery. Over the years, as the body begins to adapt to the changes, the stomach stretches and patients can eat more in one sitting.
3. Weak Bones
A study published in medical journal, The BMJ, finds that the surgery may not necessarily help improve bone strength and may even actively increase the risk of fractures.
The researchers speculated that the increased risks after surgery may be due to falls and conditions related to obesity, like Type 2 diabetes. Added to the mix are anatomical changes and nutritional deficiencies induced by the surgery.
4. Excess Skin
Since the body is losing a massive amount of weight, the skin that had expanded with all that weight, now hangs loose after the weight loss.
The treatment of the redundant skin is essential. While exercise and a strict diet are often recommended, sometimes surgery is the only option left.
4. Dumping Syndrome
Dumping syndrome occurs when the food, especially sugar, passes from the stomach to the small bowel, a little too quickly. This is because the size of the stomach is reduced and the body has to be reprogrammed.
It occurs in approximately 50 percent of the patients and causes nausea, tremors, sweating, diarrhoea, dizziness and irregular heartbeat among other things.
5. Body's Reaction Post Surgery Is Unknown
Each body is different and even after assessment, doctors don’t know how a body may react after surgery.
Bariatric surgery has a 100 percent effect. But you have no control over your body’s reactions. There are times a patient can bleed and there are times a patient can even leak.Dr Atul Peters
Only one in 400 cases can be fatal and the side-effects of the surgery have to be reckoned with for a long time. But for many, it’s a new lease on life. A handy list of pros and cons will help you make an informed choice!
(With inputs from Scroll.in, BMJ and New York Times)
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