If bariatric surgery to treat obesity is a barometer, obesity is a rapidly ballooning problem in India. People taking recourse to this surgery to lose weight has risen over 2000 percent in the last four years. From just 150 cases in 2006 to 3,500 cases by the end of November 2010.
Bariartric surgery — which costs between Rs 1.5 to Rs 2 lakh — involves reducing the size of the stomach using reversible gastic banding to make people feel full after a small meal, bringing down their appetite by two thirds.
“Too much food and inactivity are feeding the genetic predisposition to weight gain, making one in three urban adults obese,” says Dr Pradeep Chowbey, director of the Max Institute of Minimal Access, Metabolic and Bariatric Surgery, where 25-30 surgeries are done every month.
Problem of plenty
The problem of rising obesity is not unique to India. At least 2.6 million people die each year as a result of being overweight or obese. That makes obesity a bigger killer than malnutrition, shows World Health Organisation data. Body mass index (BMI) — the weight in kilograms divided by the square of the height in meters (kg/m2) — is used to classify overweight and obesity in adults.
For Indians and south Asians, being overweight means having a BMI equal to or more than 23, and obesity is equal to or more than 27. Globally, one billion adults are overweight and more than 300 million are obese. If they don’t change their lifestyle, this number will surpass 1.5 billion by 2015.
On Friday, Dr Chowbey has discharged a 26-year-old man who weighed 230 kg. “He was so overweight that he could not sit in a chair or climb stairs. After the laparoscopic surgery, he’s looking forward to losing 6-8 kg a month till he reaches his desired weight,” said Chowbey, who recommends surgery for only those with a BMI of over 32.5.
Lose and win
Most people do not need to take the surgery route. Nutritionist Naini Setalvad, 47, counsels people on how to lose weight and keep it off, from her Napean Sea Road clinic in south Mumbai. The 60 kg 5’2” Setalvad speaks from experience, having lost and kept off 100 kg for 15 years.
“I have been battling obesity since I was 13, when addiction to sweets and fried food pushed up my weight to 90 kg. Despite my swimming, gymming and trying every possible diet plan, it kept rising, touching an incredible 160 kg when I was 23,” said Setalvad.
Unable to function normally – “I did not travel for a decade because I could not take flights or get into a bus or on train” — Setalvad decided to learn more about nutrition at the age of 32. She is now 47 and weighs 60kg.
“Aerobic exercises for two hours a day and my new-found nutritional knowledge helped me lose weight and keep it off. I also had to undergo body sculpting to lose excess skin after weight-loss. Surgery is usually needed if you lose more than 50 kg,” she said.
While Setalvad did it alone, Rashmi Abhyankar, 31, took the help of VLCC to shed over 20 kg in less than three months. “When I joined VLCC, I was 27 and weighed 82 kg. I was down to 61 kg in three months, but it was regular follow-ups with the counselor helped me stay off oily snacks, which were the cause of my weight gain,” said Abhyankar, who now weighs 59 kg.
“Some people can do it alone, but I initially needed the constant counselling and guidance. I once broke down and cried when my weight plateaued and came close to giving up, but now I manage on my own,” says Setalvad.
“People now want to adopt a healthy lifestyle to feel and not just look good. That has led to VLCC growing from one centre in 1989 to over 225 centers across 90 cities in India. And 16 centers in 7 other countries,” said Dr Veena Aggarwal, Head R&D, VLCC Group.
Healthy ever after
Limiting total fat intake and shifting fat consumption away from saturated fats (oils that solidify at room temperature and those found in processed foods) to unsaturated fats, eating more fruit, vegetables, pulses, whole grains and nuts, and limit the intake of sugar and salt for a start. That, along with one hour of moderate-intensity physical activity seven days a week reduces the risk of heart disease, diabetes, colon and breast cancers.
Globally, 44 percent of diabetes, 23 percent of heart disease and 7–41 per cent of certain cancers are linked with overweight and obesity. “If options of diet, exercising for an hour a day, drugs and surgery are applied at lower levels of obesity, heart disease and diabetes can be prevented in nearly 15 per cent of the adult population of India (nearly 7 crore people),” said Dr Anoop Misra, director, department of diabetes and metabolic diseases, Fortis Hospitals.