Bariatric and Metabolic Surgery: Its future in India

Diabetes & Obesity are becoming increasingly common problems in every other household. Obesity is now recognized by WHO as a medical condition or a disease as it has various reasons and it is not just a lifestyle problem. It leads to multiple problems such as diabetes, high BP, high cholesterol (the metabolic syndrome) that in turn leads to heart attacks and strokes. What was once a Western problem has become a real problem in India. Our diet has become Westernized and we do even less exercise, as a result, obesity in India is growing exponentially and it has the third highest number of obese people in the world, after USA and China. We only have to look around to see how our family members even in the middle age (40 to 60 age group) are now starting to suffer from heart attacks and strokes. Even more alarming is the increasing incidence of Type 2 Diabetes, something that used to be a disease of adulthood, in teenage children as a result of Obesity! Maintaining their weight is often a lifelong struggle for a lot of people and often diet and exercise are not enough to maintain a reduced weight. What is more often needed is the big push which surgery gives – fast, effective & sustained weight loss, satisfaction with small meals and increased activity.

Currently, the two most common types of Metabolic surgeries done worldwide include the Laparoscopic Gastric Bypass (LAGB) and Laparoscopic Sleeve Gastrectomy (LSG). The Gastric Bypass works by both reducing the stomach into a small gastric pouch and also decreased absorption of food. The most dramatic effect of the Gastric Bypass surgery is however that it results in the immediate cure of diabetes in up to 70% of patients due to which need for injection and other diabetes medications decreases significantly. The Laparoscopic Sleeve Gastrectomy is also a great procedure as it results in loss of up to 70% of the excess weight due to both reduced sizes of the stomach and reduction in Ghrelin – the hunger hormone. Multiple long-term studies now show that Bariatric surgery leads to sustained weight loss, longer, healthier and more active life.