Health Talk

Bariatric Surgery for Weight Loss


Morbid obesity is a medical condition in which excess body fat has accumulated in the body to an extent where it causes a significant health risk. Although there are many endocrinological diseases such as hypothyroidism that can cause increased weight gain; for the vast majority who are obese (Body Mass Index greater than 30), the main causes are usually unhealthy diet and life-style. 

A diet, which is rich in carbohydrates and fats, is always likely to generate more calories than required. This combined with a sedentary lifestyle that allows little opportunity for the calories to be burnt away causes a cumulative build up of excess calories in the body, which leads on to obesity over a period of time. 
Obesity has nearly doubled worldwide since 1980. In India, it is estimated that 35% of the population is overweight and about 5 to 10 percent are obese. However, surveys conducted in urban areas of India suggest that the problem is even more severe with an estimated 50% falling in the overweight category. An extensive education and awareness programme for the general public on diet and lifestyle measures to prevent an epidemic of morbid obesity is the need of the hour. However there are many individuals who are already in a situation where they had lost the opportunity to have prevented obesity earlier in their lives.
Furthermore, even with utmost motivation and sincere following of dietary regimes and changes in lifestyle measures, they are unable to reverse their situation of obesity. These individuals are now having to live a life, knowing fully well that they have a serious life-threatening illness  of obesity, and also have to put up with all the medical problems such as diabetes, hypertension, hyperlipidaemia, arthritis and so on, that go hand-in-hand with obesity. It is for these individuals that weight-loss surgery or bariatric surgery comes as a very good treatment option. 
There are a number of bariatric surgeries described in the world literature such as Laparoscopic Sleeve Gastrectomy (LSG), Laparoscopic Adjustable Gastric Band (LAGB), Laparoscopic Roux-en-y Gastric Bypass (LRYGB) and Laparoscopic Mini-Gastric bypass (LMGB). These surgeries are performed under general anaesthesia by the laparoscopic method (keyhole surgery). These surgeries are generally very well tolerated and successful and patients tend to lose approximately 60 to 70% of their excess body weight in the first 12 to 18 months following surgery. 
During this period, patients are advised to have regular blood tests to ensure that they do not develop nutritional deficiencies. It is also expected that these patients remain on lifelong
vitamins and other nutritional supplementation tablets. It has been shown in various studies throughout the world that patients who undergo bariatric surgery not only lose weight, but also show significant remission/ cure of various associated diseases such as non-insulin dependent diabetes mellitus, hypertension, hyperlipidaemia, degenerative joint disease, polycystic ovarian disease, migraine, asthma and obstructive sleep apnea. 
Bariatric Surgery, should therefore, not be considered as cosmetic surgery and should not be understood as a surgery performed to just lose weight and make one look better, rather it should be understood as surgery that will improve one's appearance, over-all health, quality of life and as a consequence increase life expectancy.
(DR. J.K.A. Jameel is a Gastroenterologist, Laparoscopic & Bariatric Surgeon practicing in Apollo Hospitals, Chennai.)

Q. Hi Madam. I have completed my studies.  Now I urgently need a job. But I haven't got any job. What should I do? Please help me. 
(Name withheld)
Ans: Well, you have not provided your educational background for me to give you any clear-cut ideas or solutions. But I suggest you take to reading the newspapers regularly. Everyday there are ads for job openings. Further, you could go through the employment news. Nowadays there are several consultancy firms where one can register for jobs. Try looking up on the net too. Don't get disheartened so easily. At times these things take some time to work out. Keep up your spirit! All the best!
Q. Madam, I am from Dhubri district. I am the only son of my parents. I know they worked very hard in bringing me up. From my childhood days, my father was very strict. I am in my 20's now. I have the maturity to take care of my own self i.e. I know what to do what not to do. But my father's strict demeanor makes me frustrated and depressed as I was prevented from adult independence, which each and every adult like to enjoy. I was debarred from going to several social occasions - be it my friends' birthdays or local functions. Madam, Now I am totally depressed. I want to be free. Please madam, suggest something so that I get temporary relief. 
(Name withheld)
Ans: I understand how you must be feeling and empathize with you. This is a situation you yourself will have to resolve. Try and have a frank discussion with your father with regards to your feelings. If you explain clearly how you feel, your father may understand and remove few of the restrictions. 
We also have to understand that every parent has the best interest of their child. If that doesn't work, you could take the help of a family elder with whom your father has cordial relations. In the meantime, it is also important to introspect and see if you have been really behaving and carrying out your activities in a matured manner. In order to keep relaxed, you could engage in deep breathing exercises, go for a daily walk for half an hour everyday or take up some sporting activity. Stay positive!
Q. My daughter, off late, has become very quiet. She is in class 6. She doesn't share her thoughts with us and anyone else for that matter. After coming from school, she locks herself up in her room. She eats her meals in her room as well. We are trying to leave her alone. What should we do?
(Name withheld)
Ans: Please don't leave her alone. That's not a very good idea at all. Wait for an appropriate moment and try talking to her. Or request a relative with whom she is comfortable with to talk to her. Try and meet her teachers in school and find out how she is faring in school presently. This way you will get additional information. If this doesn't work, please meet with a counsellor who could help you.
Ms.Gariasi Dutta, MSW (TISS) is Psychological Counsellor with Down Town Hospital, Guwahati. She can be contacted at 98640-55560 or [email protected]