Q1: Do you think Bariatric cases are on a rise in India? If yes, what are the core reasons for this?
Ans 1: Yes, Obesity has increased alarmingly over past few decades in India. India is now 3rd most obese country in the world. Almost 3 out of 4 Indians in Metro cities are overweight or obese. Obesity is now considered a bigger health threat than malaria or tuberculosis.
Obesity is root cause to many other health problems like Diabetes, Hypertension, Cardiac disorders, Fatty Liver, Gallstones, Infertility, Osteoarthritis knee, Obstructive sleep apnoea, Cancer disorders and Depression.
The main reason for increasing obesity is westernisation of India culture, leading to sedentary lifestyle, decreased physical activity and bad eating habits.
Q2: What makes children so prone to obesity?
Ans 2: The prevalence of overweight/obesity in urban children is close to 30%. About 10% of newly diagnosed Diabetes Mellitus are in the age group of 10-18 years. Most of these are asymptomatic and picked up on screening for obesity or strong family history. The probability of becoming obese adult is 50% in obese child at 6 years and 70-80% in obese child at 13 years of age.
The factors responsible for childhood/adolescent obesity are unhealthy eating habits (junk foods, soft drinks, chocolates), reduced physical activity (increased vehicle use, reduced outdoor play, increased tv and telephones) and lack of awareness. We, as parents, should be aware of healthy lifestyle first, so that children can follow the same.
Q3: Is Bariatric Surgery the only option to treat morbid obesity?
Ans 3: Lifestyle modification, increased physical activity and better eating habits are the cornerstone treatment options for obesity. Obese people who are unable to follow or fail to above modalities are benefited from bariatric surgery.
Bariatric surgery is the only modality which provides sure, effective and permanent weight loss. Indications for bariatric surgery are BMI >40 kg/m2 with or without co-morbidities (>37.5 for Indian population) or BMI >35 kg/m2 with co-morbidities (>32.5 for Indian population). In patients with uncontrolled diabetes and BMI >32.5 kg/m2 (>30.0 for Indian population), Bariatric (Metabolic) surgery may be considered.
Q4: What are other advantages of Bariatric Surgery?
Ans 4: Obese people after Bariatric surgery don’t only shed off their excess weight, but get freed from many other co-morbid diseases. This surgery is now called Metabolic Surgery or Diabetes Surgery as it treats diabetes, hypertension, infertility and sleep disorders. It also prevents from permanent liver damage (cirrhosis), and the need of cardiac intervention or joint replacement surgery in later ages.
It gives obese people an opportunity to attain better, healthier, respectful and active life.
Q5: What are myths and misconceptions that people have about the surgery?
Ans 5: Many people are afraid of Bariatric surgery. But, advancement in technology and expertise has made this surgery much safer. Obesity and its comorbidities carry a very high risk of early death. Living with a burden of obesity is much riskier than risk of any surgical intervention. Bariatric surgery decreases long-term mortality and increases quality of life. Most of our patients are happy and healthy on long term follow-up.
Another myth is high cost of Bariatric Surgery. But a cost obese person spends on Bariatric surgery is much less than a cost he/she will spend on dealing with its co-morbidities.
Q6. Is Max Hospital an ideal centre for Bariatric Surgery?
Ans 6: We have team of Bariatric surgeon, anaesthetist, critical care, cardiology, endocrinology, gastroenterology, dietician, physiotherapy, radiology and trained nursing staff under one roof.
Max Hospital, Mohali is ‘Centre of Excellence’ for ‘Minimal Access Surgery’ where all advanced laparoscopic procedures like Bariatric Surgery, Complex Hernias, Gastro-intestinal pathologies, single incision Gallbladder surgery, Minimally Invasive Procedure for Piles and Fissure are done.
Q7: What are advancements that have taken place in Bariatric Surgery?
Ans 7: Bariatric Surgery has advanced over time as minimally invasive procedure. It carries no long incision, but done through some 5-10 mm punctures, with no stitches. This gives better cosmesis and decreased pain. Patient is discharged from the hospital in 2-3 days and can re-join his/her duties in a week time. Approximately 70% of excess weight is lost in initial 8-10 months period.
