Sunday, April 4, 2021

Bariatriatic Surgery

 The Only Mediclaim Policy at present Which covers Batriatic Surgery. Star Comprehensive Insurance Policy covers bariatric surgery and hospitalisation expenses for this procedure to a maximum of Rs 2,50,000 during the policy period*.

A fat lot of good, or is bariatric surgery helpful?
With India zooming into the fifth position on the obesity list, the number of people opting for bariatric surgery is on the rise.
CT explores the trend
With a body weight of 250 kilos, Salah was prescribed by his doctor to stick to sitting as even a single wobbly step could be fatal for him. Talking, walking and even breathing was a struggle for him. He was desperate and had no patience for a diet-and-exercise routine.Hence, he turned to surgery . Salah says, “I heard about bariatric surgeries, and spoke to the doctor.Over a period of time, they performed the surgery on me. I'm now 160kg, and still in the process of losing weight by following a diet. Now, I can walk properly and even take the stairs. Life is better now.“
Like Salah, there are many others who are opting for bariatric surgeries. A new study has found that India stands at number five on the list of countries with the most number of obese people.With obesity also on the rise in Tamil Nadu, many people are resorting to bariatric surgeries to lose weight. But not many people know the difference between bariatric surgery and liposuction. And not many understand how it helps those who are morbidly obese to lose weight. Chennai Times speaks to experts in the field to explore the various facets of bariatric surgery ...
WHAT IS BARIATRIC SURGERY?
Dr Raj Palaniappan, director and chief bariatric surgeon at a city hospital, says, “Obesity is on the rise in India (any person whose BMI is 30 and over is considered to be obese). Tamil Nadu has one of the highest obesity rates in the country , and Chennai, the highest number of morbidly obese people, owing to our high-carb diet. Since obesity increases the risk of heart disease, high blood pressure, diabetes and cancer, in some cases, many people opt for surgeries to lose weight. For this reason, bariatric surgeries are on the rise. We don't perform surgeries just like that on anyone.We have certain guidelines to follow. The first thing is BMI. The international criteria to do bariatric surgery on someone is if heshe has 32.5 BMI or over. We then evaluate their medical history and do the procedure.“
So, what happens during the surgery? “Doctors either remove a portion of the stomach to make the stomach look like a sleeve (sleeve gastrectomy) or reduce it using an implant (gastric banding). For people with morbid obesity (person whose BMI is over 40), the stomach is made smaller, which helps restrict entry of food into the small intestine (gastric bypass). This reduces the intake of food and absorption of calories. There are different types that we follow according to the person's weight and risk involved. We also do it by sittings, again depending on their weight,“ says Raj. And bariatric is not given as an option for all.Dr Deepak Subramanian, consultant ­ minimal access and bariatric surgeon, says, “If they are on the borderline, we take them through a medical management structure. We counsel them on food habits, alter their lifestyle, give a customised diet plan and suggest fitness activities. Many people have lost weight through this approach. But if the risk is greater, only then we suggest bariatric surgery. But even for this, we assess if they are fit for the surgery . Some people might have issues like diabetes or respiratory prob lems, so we go through a pre-opera tive procedure first and then go in for a surgery . Many people still think that it is a cosmetic proce dure, but it is not.“
The procedure can be anywhere between 30 minutes and two hours.
IS IT RISKY? The risk percentage is not too much says Dr Raj.
“ T h e risk of s u c h s u r g e r ies is around 7-8%. We are on par with international standards,“ says Raj. Agrees Deepak, “There are very few bariatric surgeons in the country who have proper license to perform such procedures.So, the risk factor is less as we follow international standards. But there is a surgical risk like any other procedure and long-term risk if people don't do regular follow-ups.“
POST-OPERATIVE CARE IS IMPORTANT
While many associate this surgery to be a onetime solution, doctors advice that it is important to come for regular check-ups. Dr Raj says, “Any surgery requires post-operative care. Bariatric surgeries are not a one-stop solution. We ask patients to come for follow-ups every few months. We constantly monitor their diet and keep making some alternations. Also, some nutritional elements are lost during the process.So, we put them across to the nutritionist who gives supplements. We create awareness about all this in the first sitting itself. No matter how much weight you have lost, you need to follow a healthy lifestyle for life.“
But there have been a few cases of relapse as well. “People who have undergone the surgery might not be regular with their food habits or in their intake of supplements. So, they might have put on a few kilos in a span of few years. So, we see if it can be corrected through diet management or if it needs follow-up surgery,“ says Deepak. What about battling issues like skin sagging post surgery? “This is corrected only through a cosmetic surgery,“ says Raj.
Flora Ambani, who went through a bariatric surgery, says, “I did bariatric sur gery on the advice of my doctor. I was weighing 125kg and was unable to sleep properly. Even if I did, I was snoring a lot and wasn't able to move around properly .
But after the surgery, I lost around 20kg. I still continue to lose weight. I am in regu lar contact with my doctor and continue following a healthy lifestyle.“ A lot of celebs, too, have opted for surgeries.
WOMEN OPT FOR SURGERIES MORE THAN MEN
Interestingly, women opt for bariatric surgeries than men. Talking about male-female ratio, Dr Deepak says, “They are more obese and at the same time, are also conscious about their health and appearance. Also, women face a lot of infertility issues when they are obese. This is one of the reasons why they opt for surgeries more than men.“
OBESITY AND THE HEART
Doctors say that obesity increases cardio vascular risk four-fold.Cardiologist I Sathyamurthy says, “In India, more than 15% people are obese. Factors like physical inactivity, high-calorie diet and thrifty gene (genetic problems) contribute to obesity. And this increases the chances of getting cardio vascular problems, which, in turn, reduces life expectancy. Other issues like high BP, diabetics, sleep apnea and cardiac rhythm problems are also associated with it. Having a healthy diet and regular exercise can only help you lose weight. Only if you have gone beyond that, doctors opt for bariatric surgeries,“ says Sathyamurthy. He also adds that even slim people should get their fat percentage checked. “A lot of visceral fat in their body (fat percentage in the stomach) might contribute to health issues. So, they must keep a check on the BMIs and fat percentage,“ he adds.
SURGERY IS NOT THE ONLY OPTION
Adnan Sami For singer-musician Adnan Sami, surgery was not an option. “I was weighing more than 100kg. I considered bariatric surgery first since it was impossible for me to lose weight. I even met the doctor, but he asked me if I would be able to lose weight by following a proper diet. I then met a dietician overseas, who gave me customised chart. It took over a year to see a considerable change. I was happy, though. It is undoubtedly difficult, but with the help of a good support system, I was able to achieve it. Till today, I follow a certain lifestyle to maintain the weight.“
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