Twenty-three-year-old Manish, who has a family history of obesity, started battling obesity at a very young age in life and was caught in a vicious cycle of weight gain, low self-esteem and depression due to comfort eating and constant weight gain. He had been trying to lose weight through dieting and exercise for the last two years, but when things stopped after losing 10-12 kg, he would give up, which became a constant source of frustration for him.
Later, on medical advice, he underwent bariatric surgery and lost 15 kg in a month and was easily able to follow the recommended diet due to a reduced appetite. Within a month of the surgery, Manish started exercising vigorously and took things to the next level with self-encouragement and within a year, he lost 60 kg and went from 150 kg to 90 kg and gained significant muscle mass.
Exercise became his new obsession, so much so that it helped him follow a strict diet that eliminated carbohydrates almost completely! This successful case underlines the importance of bariatrics in the current scenario.
In an interview with HT Lifestyle, Dr Vikas Singhal, Associate Director, GI Surgery, GI Oncology and Bariatric Surgery at Medanta, Gurugram, shared, “Weight loss surgery, bariatric or metabolic surgery are several terms used to treat patients suffering from obesity and the health complications that result from it. The surgery has become very common and can be truly life-changing for patients. This surgery is a weight loss procedure that alters the digestive system to aid weight loss. It is often performed when diet and exercise are not effective or when serious health problems arise due to weight. Some procedures limit dietary intake, while others reduce fat and calorie absorption.”
A positive attitude is required
Dr. Vikas Singhal said, “Changing the perception about obesity is the first effective step to combat this epidemic. It is important to understand that obesity is a “disease” and not just a cosmetic issue. Anyone considering surgery needs to understand the lifestyle changes that come with the surgery and the guidelines that need to be followed. Secondly, it is important to know that bariatric surgery is not a cosmetic procedure where some body fat will be removed. This surgery “resets” the body’s GI system.”
He said, “In fact, this is a procedure in which the effectiveness of the surgery depends on the user. Any person can really get a lot of help from this procedure and can benefit a lot from it for themselves by following the diet and exercise recommendations and can lose most of their excess weight and get rid of diabetes, high blood pressure, stroke and many cancers. The surgery can greatly improve not only physical but also mental health.”
Types of bariatric surgery
According to Dr. Vikas Singhal, there are several types of bariatric surgery that are typically performed either laparoscopically or with robotic assistance. He explains, “Surgery works in several ways, including restricting diet, reducing food absorption, and most importantly, the metabolic or hormonal changes that occur with the surgery. Common types of bariatric surgery include Roux-en-Y gastric bypass, sleeve gastrectomy, biliopancreatic diversion with duodenal switch (BPD/DS), and single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S).”
Dr. Vikas Singhal elaborates, “The Roux-en-Y gastric bypass is the most common method, and it is usually not reversible. It works by cutting the upper part of the stomach, separating it from the rest of the stomach, and sewing part of the small intestine onto the pouch. Sleeve gastrectomy removes about 80% of the stomach, creating a long, tube-like pouch that can hold less food and produces less of the appetite-regulating hormone ghrelin. Benefits of this procedure include significant weight loss, no redirection of the intestines, and a shorter hospital stay. Also, biliopancreatic diversion with duodenal switch is a two-part surgery that limits eating and reduces nutrient absorption.”
So then who is this surgery really for?
Dr. Vikas Singhal explains, “Bariatric surgery requires specific criteria based on universal standards. These include a body weight greater than 45 kg, a BMI greater than 37 or 32 with obesity-related medical complications, a documented history of weight management and weight loss efforts, and no signs of active alcoholism, active drug addiction, or any major mental disorder. Other criteria, such as age and general health, are also evaluated. After determining the suitability for surgery, a nutritional assessment is performed, and supportive structures may be put in place.”
They concluded, “In some cases, a different type of surgery or alternative treatment may be recommended. Bariatric surgery can lead to long-term weight loss, resolving conditions such as heart disease, high blood pressure, cholesterol, sleep apnea, type 2 diabetes, osteoarthritis, joint pain and skin problems. They improve daily activities and quality of life but permanent changes in diet and exercise are important for long-term success. In most cases, bariatric surgery reduces the risk of life-threatening health problems.”
Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice. Always seek the advice of your doctor for any questions about any medical condition.
