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Marketing feature

THEWEEK dEcEmbEr 4, 2011

Lose and win

Bariatric surgery is the treatment choice for morbid obesity
onsidered to be the disease of the west, obesity, has reached epidemic proportions even in India, with over all 12 per cent of the countrys population being obese and morbid obesity affecting another 5 per cent. Genetic factors along with unhealthy, erratic eating habits, lack of exercise and sedentary lifestyle contribute to this deadly disease. Morbid obesity (abnormally high accumulation of fat within the body) is the most important and poorly understood form of obesity. Although loads of information is available regarding obesity, many are still unaware of the treatment options and often delay, until it worsens. It is crucial to first identify the problem and deal with it appropriately. The most commonly used tool in identifying is the Body Mass Index (BMI), which is nothing but the measure of body weight (Kg) in relation to Height (Mt). BMI=Kg/Mt2. Bariatric surgery has proved to be the most reliable and effective form of treatment for morbid obesity. The patients who qualify are the morbidly obese and also the the ones associated with comorbidities such as diabetes, hypertension, sleep apnea and arthritis etc. Bariatric surgery has grown more than tenfold in the last decade and is still continuing to grow with more and more centres offering these services. It is usually performed as a laparoscopic (key hole) procedure, where the patient will have four to six tiny cuts on the tummy with minimal pain, faster recovery, and a hospital stay of three to five days. It is comparatively a safe procedure with the patient being back on their feet the same day of surgery, and back to work within a week or two. Not only does the surgery help to reduce weight but also to control high blood sugar, to treat obesity related diseases like type II diabetes mellitus, hyperten-

sion, sleep apnea (interrupted breathing during sleep), poly cystic ovarian disease, arthritis and high blood cholesterol levels. Data shows that bariatric surgery helps to control diabetes in 80 to 85 per cent of patientseven those on insulin injections. The results are much better on people who had diabetes for less than a decade. The control is about 60 to 70 per cent in people who had diabetes for more than 10 years. It is also shown that weight loss resulting from this surgery helps to restore the normal hormonal balance of the body, which improves the health and well-being of the patients. Because of these factors the nomenclature of the surgery has been changed in the west to Metabolic Surgery.

ach and small intestine is bypassed, so that food and digestive juices mix with each other distally. In Sleeve Gastrectomy, approximately two-third of the stomach is stapled off. This results in a stomach, which is roughly the size and shape of a banana or Sleeve.

Complications/side effects of bariatric surgery include:

Types of bariatric surgery

Breakdown/leak of the pouch which requires revision surgery Narrowing of the opening between stomach and the intestine, which can be corrected by endoscopic dilatation and/ or surgery? Anaemia, which is taken care by supplementing the patients with iron, vitamin B12 and multi-vitamin preparations. Calcium deficiency needs calcium supplements.

The most commonly performed are the Gastric bypass, Sleeve Gastrectomy and the Gastric band, which is rare nowadays. In Gastric bypass, a small stomach pouch is created and leading to early satiety/satisfaction with small quantity of food and essentially a large part of stom-

Dr Vinodha Reddy K MBBS, MS, DNB, FRCS (UK), is a consultant in Surgical Gastroenterology and Bariatric Surgery, Manipal Hospital, Bangalore

Email: vinodh.reddy@manipalhospitals. com