Fat chance in slim surgery - Bariatric procedure holds out hope for 'morbidly obese'

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By RITH BASU
  • Published 2.06.11
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Remember how fat Maradona had become circa 2005? The soccer legend had gastric bypass surgery to shed the flab

Noor Saba, 28, weighed 100kg till last December. The Park Circus homemaker would tire after taking a few steps. Her snoring was so loud that it brought complaining neighbours to her door.

Uma Sharma, 57, weighed 115kg and had become wheelchair-bound. She had developed acute diabetes, requiring her to take 120 units of insulin each day.

Noor is a lean 66kg now and even took her kids out to Nicco Park. Her snoring has also disappeared. As for Uma, she weighs just 81kg and no longer needs her wheelchair. What’s more, her diabetes is under control. She requires just eight doses of insulin.

It’s not magic but bariatric surgery that made it possible.

The procedure, which achieves weight loss by reducing the size of the stomach through surgery and altering hormone secretions, is slowly catching on in Calcutta, changing the lives of the “morbidly obese” who suffer from associated diseases like diabetes, hypertension, cardiac problems and immobility.

Explaining the procedure, bariatric surgeon Om Tantia, the director of ILS Hospital, said it was possible through bariatric surgery to shrink the stomach with laparoscopic intervention. This means that patients will feel full after smaller meals, leading to sustained weigh loss. Certain hormones — such as ghrelin and GLP1 — which influence weigh gain, also get regulated because of the surgical intervention.

“I used to suffer from low self-esteem because girls never looked at me,” said Kushan Basu (name changed), a college student who used to weigh 135kg. After bariatric surgery, however, he is a much fitter 80kg.

According to gastroenterologists, bariatric procedures have risk factors too — such as developing bloatedness and diarrhoea, incisional hernia and leaks at the surgical site or infections, though the mortality rate is just 0.2 per cent.

“Frankly, patients have to take a call, weighing the pros and cons. It’s about getting cured of their present ailments and ailments they are susceptible to, against what the surgery would entail, including continued restrictions on food intake,” said a city-based surgical gastroenterologist.

“The morbidly obese have respiratory and mobility problems. It’s useless to ask them to exercise. Sometimes, they eat so little that you cannot tell them to eat any less. In such cases, bariatric surgery is the only scientific intervention possible,” said Sarfaraz Baig of Bariatrics and Metabolism Initiative (BMI), at Belle Vue Clinic.

He stressed that bariatric surgery is not a cosmetic procedure, but a life-saving one, and that one should go for it only if the body mass index (weight in kg/height in metre squared) is at least 38.5 — the ones classified as “morbidly obese”.

Calcutta now offers several kinds of bariatric surgeries (see below), that cost anything between Rs 1.5 lakh and Rs 3 lakh (excluding medicines). Surgeons Baig and B. Ramana of BMI have started performing a “gastric plication surgery”, which involves “plicating” the stomach with running stitches layer by layer. With most of the stomach pushed inwards, the passage inside becomes narrow. This surgery costs Rs 1 lakh but, being a new technique, doesn’t come with too many case histories for the patient to go by.

Procedures available in Calcutta

» Sleeve gastrectomy: A portion of the stomach is surgically removed

» Gastric bypass: Stomach divided into a smaller upper pouch and large lower pouch; small intestine re-routed to the smaller pouch, bypassing the larger pouch

» Gastric banding: Stomach reduced in size with an implant

» Gastric plication: Stomach pushed inwards with running stitches, narrowing passage inside