Weight-loss surgeries: the changing trends

Obesity is more than not being able to fit into old clothes. It is a ‘killer life­style disease’ which accompanies a number of co-morbidities and adverse health outcomes, emerging to become one of the most important causes of preventable deaths across the globe.

Weight loss surgeries have gained prominence in the recent past owing to crumbling lifestyle changes. With 80% of all diabetes cases reported in India caused by obesity, bariatrics is no more considered as a cosmetic option but as the finest option available to bring one’s healthcare back on track. Even World Health Organisation (WHO) recently recommended bariatric surgery as an important tool to cure diabetes.

Anyone who has a Body Mass Index (value derived from one’s weight and height) between 35-40 kg/m2, in the age group of 18-65 and have associated serious weight-related problems such as diabetes, high blood pressure, arthritis or heart disease could look at opting for bariatric surgery. Some of the major forms of bariatric surgeries currently available in India include laparoscopic gastric sleeve gasterectomy, gastric bypass, mini gastric bypass etc.

The most popular and the most frequently performed procedure globally is the laparoscopic gastric sleeve resection. This procedure reduces the capacity of the stomach and subsequently, the quantity of food consumed is reduced.

Another common laparoscopic surgery method is sleeve gastrectomy. For high-risk patients and extremely obese patients, this surgery works rem­arkably well. In this procedure, the left side of your stomach is surgically removed to red­uce food intake. Since it does not involve any rerouting to intestines, it is a fairly simple procedure as opposed to a gastric bypass or duodenal switch method.

A gastric bypass surgery — there are many options available within it — aims to alter the process of digestion. This procedure used to be the most popular one prior to the introduction of sleeve gastrectomy. The bypass procedure reduces the capacity of the stomach and also reduces food absorption.

Another interesting endoscopic procedure which is not a surgery is the Endoscopic Intragastric Balloon. As the name suggests, a balloon is placed in your stomach for 6 months which occupies about half the volume there. This is a temporary procedure for a short period and is useful for patients who are not fit for surgery.

Careful diet plans

All these techniques require careful diet plans and follow-ups to initiate a healthy weight loss. These bariatric procedures require full anaesthesia. Since they are performed by laparoscopy (through key hole) it requires a hospitalisation of 2-3 days. Post this, you can be back to work within 10 days. The food restrictions are to be followed for about a month to foster a healthy healing.

However, these abdominal surgeries can turn out to be risky if not performed under utmost precision and experience. The potential complications could vary from bleeding, infection pneumonia, leak from stapled area to pulmonary or renal failure.

But, experience counts and if conducted by experienced consultants, it could have an extremely low complication rate. Also, after the surgery, a patient will be advised to keep a track of what they eat and how much they eat. It is a cohesive approach that will eventually lead you to your desired results.

With more than 18,000 weight-loss surgeries conducted in India till recent years, there has also been a change in preference by patients. Of late, most prefer gastric sleeve surgeries. The reasons often cited for this is the lesser risk factor, fewer long-term complications, and more normal experience of eating associated with the surgery. Doctors also suggest this option for patients with diabetes and GERD or acid reflux.

Another trend has been the increase in number of private pay patients, since it is a Herculean task to wade through the stringent approval processes for claiming compensation for bariatric surgeries. Since these surgeries are considered to be life-saving procedures, it is time that insurance companies include these procedures in their list of authorisations.

With improving long-term effects in bariatric surgeries and increasing awareness among people, weight loss surgeries are witnessing a surge in demand. With many options to choose from, both patients as well as physicians can work in tandem.

Additionally, with the length of procedures becoming shorter as well, the approach towards them is turning more inclusive and weight-loss surgeries are surely marking a change towards better lifestyles.

(The writer is Senior Consultant and bariatric surgeon, Apollo Spectra Hospitals, Bengaluru)

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