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Bariatric surgery right way to lose weight

Dr Sandeep Malhotra

Obesity is a problem with people across the world. With economic progress, a large percentage of urban Indians are obese. Obesity is a disease that increases the risk of diabetes, high blood pressure, heart attack, cancer and premature death.

Obesity is caused by multiple factors. The most important ones are poor diet, lack of exercise, genetic factors and hormonal changes. A poor diet includes large portions, fried foods, sweets and snacking between meals.

A person is considered severely obese when the body mass index (BMI) is 32.5 or more. The BMI depends on the height and weight of a person. High weight can affect health adversely and cause premature death.

Most severely obese individuals have tried to lose weight with diet control and exercise. Even if they get temporary success, unfortunately they re-gain the weight they had lost, plus gain some more. This "Yo-Yo" effect is even worse for health.

Bariatric or weight loss surgery is the only means of successful and durable weight loss among those who have tried other means. The most popular surgeries are:

Lap Band: An adjustable band is placed on the upper part of the stomach. This reduces stomach capacity and hunger.

Roux-en-y Gastric Bypass: The stomach is divided into a small pouch the size of a golf ball, and a part of the intestine is bypassed. This reduces hunger, makes a person feel full quickly and a part of the food is not absorbed into the body.

Sleeve Gastrectomy: Eighty per cent of the stomach is removed leaving a narrow sleeve of stomach behind. A person feels less hungry as a hormone called Ghrelin, which is responsible for hunger, is no longer produced. In addition, the person feels full quickly during a meal.

All these operations can be done laparoscopically so that the patient spends only one to two days in the hospital and can return to their daily routine quickly. Patients can lose 50-80 per cent of their excess weight over 1-2 years. However, regular follow-up with the surgeon and good diet and exercise are important to maintain the weight in the long term.

Dr Sandeep Malhotra is consultant, Bariatric Surgery, at Artemis Health

Institute, Gurgaon