Obesity and Bariatric Surgery

In a country like India, where 270 million people live below the poverty line, obesity is not a far off
issue. According to a study, India happens to be the third most obese country in the world. Owing to
our high-calorie carb diet, lack of exercises, excess consumption of alcohol and genetic factors, one in
every five men/ women is either overweight or obese. Obesity leads to diabetes as well as cardiac
diseases. This is another reason why India is known as the diabetic capital of the world and the number
is on a constant rise.
During a Webinar session called NH dialogues, Dr. Devi Shetty, Chairman of Narayana Health, Dr.
Satish Kumar - Head of Endocrinology and Bariatric medicine, Dr. Shuboi Banerjee - Bariatric,
Laparoscopic and BI Surgeon, Narayana Health, Kolkata, and Dr. Ashwin Kumar - GI Surgeon, discussed
a list of questions regarding obesity.

What is obesity?
Obesity is defined as the excess amount of body fat. The scientific method of measuring obesity is
called body mass index (BMI), calculated based on the ethnicity, height, weight and age of a person.
In India, the normal BMI is between 18.5 and 23. Anything between 23 and 27 is termed as overweight
and above 27 is termed as obese. Obesity is caused due to genetics or hereditary and also due to
consumption of high amounts fast foods, high calorie junk foods, sodas, overly sweetened desserts,
etc. It also has a lot to do with hormonal imbalance.

What is bariatric surgery?

Bariatric surgery or weight loss surgery is performed on people who have very high BMIs of 35-40.
Such BMIs can be life threatening. There are three types of bariatric surgeries performed. The first
surgery is done using a gastric band with the help of staples. This method is called Roux-en-Y Gastric
Bypass (RYGB). The second method is done by removing a portion of the stomach and is called sleeve
gastrectomy. The last is done by resecting or re-routing the small intestines to a small stomach pouch.
All the above procedures aim at reducing the size of the stomach, thereby, reducing the intake of food.

How safe is bariatric surgery?

According to the international standards, bariatric surgery has recorded a mortality rate of less than
1%, hence, making it one of the safest and most effective surgeries. However, the patient needs to be
thoroughly analyzed and determined as fit and healthy for operation. This means, if a patient has
diabetes, BP, hypertension or cardiac issues, they should be treated first before opting for a bariatric
surgery. In rare cases, the surgery might have some diverse effects.

Benefits of bariatric surgery

With bariatric surgery, the patient can lose up to 60-80% of their excess body fat within 2 years. But,
the benefits of bariatric surgery are not limited to just weight loss. It also helps patients resolve other
diseases such as diabetes, high blood pressure, heart diseases and many more. As a matter of fact,
the surgery helps cure diabetic patients for good. The bariatric surgeons (Dr. Ashwin and Dr. Shuboi)
stated that the surgery can be opted as an alternate cure for diabetes as it can cure diabetes up to
80% and reduce the intake of diabetic medicines up to 20%. Dr. Ashwin added that the surgical results
were better for a younger patient, owing to the advantage of younger metabolism, higher resistance,
stronger antibodies and hormonal factors.

Recovery time and cost

Bariatric surgery has probably one of the fastest recovery times for a patient to get back on his feet.
Post operation, he/she needs bed rest for about 4 days and in just 7-10 days, the patient can regain
normalcy, i.e. travelling to office and engaging in other daily activities. A minimalistic bariatric surgery
may cost around 2-3 lakhs including medicines. If the patient requires additional comfort such as a
private hospital room, a personal medical assistant, etc., the price may increase accordingly.

Post recovery care

Once the surgery is done, the doctors at Narayana Health advice patients to follow strict healthy diet
and exercise daily in order to achieve an optimal weight loss result. Patients need to realize that its a
life-long commitment and must be taken seriously. An alternate way to lose weight can be achieved
by taking medicines. However, the results may not be as effective or long-lasting as achieved through
bariatric surgery. Watch full length webinar at https://www.youtube.com/watch?v=Ke_gFweve6A

About Narayana Health:

We are headquartered in Bengaluru, India, and operate a national network of hospitals in India with a particularly strong
presence in the southern state of Karnataka and eastern India, as well as an emerging presence in western and central India.
Our first facility was established in Bengaluru with approximately 225 operational beds and we have since grown to 57
facilities with 5,442 operational beds as on Jan'16, through a combination of greenfield projects and acquisitions. We believe
our "Narayana Health" brand is strongly associated with our mission to deliver high quality and affordable healthcare services
to the broader population by leveraging our economies of scale, skilled doctors, and an efficient business model.
In aggregate, our centres provide advanced levels of care in over 30 specialties, including cardiology and cardiac surgery,
cancer care, neurology and neurosurgery, Orthopaedics, nephrology and urology, and gastroenterology.
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Includes 56 facilities in India and the 1 facility in the Cayman Islands operated by our associate company, HCCI.
Includes facilities and beds across hospitals that are owned, operated, leased and managed, and the 101
operational beds and 104 capacity beds facility in the Cayman Islands operated by our associate company, HCCI.

For more information about Narayana Health, visit http://www.narayanahealth.org/