Dr Aparna's OPD at Apollo Hospital

Hi,

I am Dr. Aparna Govil Bhasker, Bariatrician with an experience of about 13 years practicing in Mumbai. I deal with patients who are suffering from obesity. First thing I would like to share that obesity is a disease. Whenever we see the patient we see that somewhere they are also responsible for the weight that they are carrying. So, the first thing we need to realize that obesity is a disease like any other chronic disease. It is very similar to diabetes or heart disease and the progression is very similar to various stages. Today we define the stages on the basis of body mass index. That is the parameter that we use. So, if the BMI is between 23.5-27.5 then these patients are considered to be overweight. People between 27.5-32.5 suffers from grade 1 obesity. Any person with BMI more than 32.5-37.5 suffering from grade 2 obesity. Any person whose BMI is more than 37.5 suffering from grade 3 obesity.

When we talk about bariatric surgery, it is actually a treatment option for grade 3 obesity. And sometimes, for grade 2 obesity with 2 associated diseases like diabetes, hypertension, sleep apnea or say any other problem which is associated with obesity. The treatment will depend upon the grade of obesity. Now when we talk about bariatric surgery, it is basically a laparoscopic surgery, gastrointestinal surgery where we actually reduce the size of the stomach and some kind of surgeries where we re-route the intestines and join it to the stomach. There are 2 types of surgeries which are commonly performed in India: Laparoscopic sleeve gastrectomy. In this, we divide the stomach vertically. We create a small tube of the stomach. In this 65% of the stomach is removed out of the body. So, a small tube of the stomach remains inside the body. So, the amount of food gets reduced and they feel full early.

Another advantage, the person doesn't feel hungry much after the surgery. The other surgery is called a laparoscopic gastric bypass. This is one of the common and oldest surgery. It has one of the best results. In this small pouch of the stomach is created. So, here we are not removing any part of the stomach, we actually re-route the intestine to reduce the size of the stomach. This also has similar effects. The person is able to eat less. They don't absorb all the calories from the food. Now, it totally depends upon the patient's clinical profile. After a thorough evaluation, we see what surgery will be comfortable. All surgeries will lead to 65-75% of excess weight. Bariatric surgery also leads to very significant results and improves the quality of life. Associated diseases like diabetes, high blood pressures, sleep apnea, liver disease, lung disease, all these leads to a lot of improvement after bariatric surgery and overall health of the patient improves.

Weight loss happens over a period of about a year-year and a half. Most patients are able to maintain their weight. For the long term of weight maintained, a little bit of work is required from the patient's end as well. We do some degree of lifestyle and behavioral modification. Follow-up is a very important part of the whole program. Because good follow-up and great attendance keep the patient motivated. So, bariatric surgery is safe. In the end, I would like to say that when you are suffering from obesity, if you do not get treated properly, there are repercussions for that. And that can actually lead to a life-threatening problem. Doing surgery is always a risk and patients always think twice about it. But doing bariatric surgery for obese patients is much better than going into further risk. If you have any query regarding weight loss or bariatric surgery, you can contact me through Lybrate.

Thank You!