Dr Pradeep Chowbey's operating rooms (OR) at New Delhi's Max Institute of Minimal Access, Metabolic and Bariatric Surgery look different from other ORs: the doors are wider, the massive operating tables support weight upwards of 300 kg, and surgeons stand on platforms to operate. Preparing patients for surgery involves bolstering and strapping their arms, shoulders and legs to prevent them from moving during surgery.It's the excess weight that patients come here to lose that makes surgery a challenge. "As weight increases, everything - anaesthesia, positioning and surgery - take longer," says Dr Chowbey, who is among the busiest weight-loss surgeons in India. His team has to cut through layers of abdominal fat just to reach the small intestine and stomach to begin surgery, which takes roughly two and a half hours.
Bariatric surgery is not a shortcut to weight loss but a treatment for obesity-related diseases such as hypertension, diabetes, arthritis, high cholesterol and sleep disorders, among others- Dr Pradeep Chowbey, Chairman, Max Institute of Minimal Access, Metabolic & Bariatric Surgery.
With 30 million of India's adult population overweight and obese and 62 million diabetic, weight-loss surgery is growing at 8% annually. "Roughly 15,000 procedures were done last year, up from 5,000 just three years ago," says Dr Muffazal Lakdawala, chairman, Institute of Minimal Invasive Surgical Sciences at Saifee Hospital, Mumbai.
"It's not a shortcut to weight loss but a treatment for obesity-related diseases such as hypertension, arthritis, dyslipidemia (high cholesterol and blood fats), acid reflux, sleep disorders and diabetes," says Dr Chowbey.
Long-term data from 150 patients operated in Delhi between 2006 and 2009 shows surgery helped control diabetes in 88.4%, lower hypertension in 58%, increase heart-protecting good cholesterol (HDL) in 93%, and triglycerides in 82.1%.
Before his surgery in 2012, Anil Wadhwa, 53, weighed 186 kg and had diabetes, high blood pressure, chronic back pain and rheumatoid arthritis. "I was bedridden for six years, anything would have been an improvement over the life I was leading," says Wadhwa. He was in luck. He lost 72 kg after surgery and now weighs 114 kg.Bariatric surgery is done laparoscopically, with the surgeon operating through four small incisions in the abdomen. It costs `2-3 lakh, including three days of hospital stay. After surgery, most people begin to lose an average of 6-8 kg a month, usually stopping when they are about 10% higher than their healthy weight. The weight loss is permanent.
Over the past year, the numbers of teens undergoing surgery has shot up. "We're getting bigger teenagers with obesity-related diseases and there's often no choice but to operate," says Dr Lakdawala, who's youngest patient is 13. "He weighed 160 kg, had uncontrolled hypertension, diabetes, sleep apnea and dyslipidemia, but since he met the skeletal mass parameters, I operated. He's lost more than 50 kg," says Lakdawala.
The skeletons of obese adolescents are usually more dense than those of normal weight teens, but return to normal within two years after gastric bypass surgery, reported US researchers in March at ENDO 2015, the annual meeting of the Endocrine Society in San Diego. Dr Chowbey's youngest patient was a 13-year-old weighing 154 kg, with severe asthma and breathing problems. He now weighs 91 kg.
LESS IS GOOD
Sunita Gupta, 43, underwent bariatric surgery last week at Max Hospital to control her galloping weight, which was a staggering 119.6 kg for her 5-feet frame. "I can barely walk, I can't get clothes my size, I don't go out," says the mother of two.
Gupta hopes surgery will fix her high blood pressure, osteoarthritis, hypothyroidism, distorted joints, varicose veins and disrupted sleep. Her target weight is 69.4 kg, which she hopes to reach by the year end.
Archana Malik, 56, weighs 65 kg after undergoing surgery three years ago. "My weight's not ideal, but I'm happy," says Malik, who weighed 105 kg in 2012. "I put on weight after my girls were born and though I tried crazy amounts of diets, my cholesterol stayed high, my weight was horrendous and I had aches and pains," says the Gurgaon-resident.
After surgery, she's happier than she's been in years. "The first six months were tricky, I was unsure about how much to eat, but now my life has turned," says Malik. "I absolutely recommend it to everybody."