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Weight Loss and Nutrition
Weight Loss and Nutrition

Weight loss medications and injections… a new era of medical weight loss or weight management

25/03/2025 No Comments

Incidence of obesity is on the rise globally. In India almost one out of 3 to 5 would have some degree of excess weight. The reasons are many and hence obesity is known as a multifactorial disease.

Genetics can contribute to obesity. Environmental factors such as preservatives, pesticides, etc. are the known endocrine disrupters. Environmental factors also have impact on epigenetics. Life style does play a role in aggravating the grade of obesity. Diet and life style change as a treatment of obesity has been attempted over many decades but could never give a long-lasting sustained success. The obvious reason being the body’s physiological response which gains the weight back. Hence, treating the root cause, that is the hormones of metabolism, is important for long-term control of weight.

Bariatric surgery was the only known and accepted treatment of obesity which could improve the hormones and metabolism. Bariatric surgery is known to reduce the hunger hormone Ghrelin and increase the GLP1 hormones. These hormones increase metabolism and help in weight loss. Researchers always attempted to create anti Ghrelin hormones but still it is not successful. The other attempt was to create a hormone which would work like GLP1 hormone. The newer medications or injections are the hormones like GLP! And hence are called hormone analogues/ GLP1 analogues. Like GLP1, there exist many hormones in the body like glucagon, GIP, amylin etc. which also have impact on hunger, appetite, and weight loss. Newer injections may have a single hormone or a combination of these.

Which drugs are known as weight loss medications /injections :

Injections like Liraglutide, Dulaglutide, Semaglutide , Tirzepatide etc are the newer medications for weight loss known as Victoza, Trulicity, Wegovy, Ozempic, saxenda, Mounjaro. There are some oral medications available like topiramate with phenteramine and bupropion with naltrexone.

How effective are these medications or injections?

These medications are effective and can give 5 to 15% weight loss based on various factors. It is necessary to follow a healthier and nutritious diet with these medications to minimise the side effects of these medications. The result of these remains variable and not the same for everyone. Majority of patients lose up to 5% weight.

What are the precautions before starting these medications and what are the side effects?

Patients may experience bloating, acidity, symptoms of reflux, some people may develop constipation or diarrhoea. Those with preexisting reflux, acidity or bowel disturbances should consult their doctor before starting these medications.

Incidence of thyroid cancer is reported with these medications, even though low. Those with thyroid disorders should consult their doctor and get thorough evaluation prior to initiation of therapy with these new medications. Those looking for conception/ pregnancy should avoid these medications or strictly use contraception while on these drugs.

Pancreatitis and gall stone disease are seen after the use of these weight loss injections. They should be best avoided in patients with history of gall stone disease, biliary diseases and those with history of pancreatitis.

A small number of patients have also reported changes in the mood, depression, anxiety, and suicidal thoughts after the use of these newer injections. Those with existing mood disorders or those on psychiatric medications should be screened prior to the use of these medications.

The drugs work by slowing the stomach movement, also known as delayed gastric emptying. A condition called gastroparesis has been reported which means the stomach start remaining paralysed and food remains in the stomach for longer period. This may give rise to bad breath, reflux and sometimes vomiting or reflux during sleep may be dangerous. Those with severe sleep apnoea should avoid heavy meal at bed time and should consult their doctors. The medications should be stopped two weeks prior to any surgery or anaesthesia for fear of vomiting and aspiration.

How long should one use these medications? Can someone stop these medications after achieving satisfactory weight loss?

It has been reported that if the medications are discontinued, there is increase in hunger, slowing of metabolism and rapid weight regain. Hence it appears that these medications have to be continued for life time, even though long- term side effects and safety is still yet to be known.

In simple language, these are just like a blood pressure or diabetes medications. The effect is seen till you consume those medications. Obesity being a chronic genetic, metabolic disease the treatment has to be continued ever.

Are these medications cost effective? Are they covered in insurance?

It appears that the medications cost around 20000 to 40000 Rs per month if you consider all the supplementary medications like statins, other medications, treatment of symptoms of side effects and protein and vitamin supplements. One may calculate the cost over a few years.

At present these are out patient treatments and hence not covered under insurance. Only bariatric surgery is covered under insurance and is known to be most cost effective as compared to these medications.

LOC or Laparo Obeso centre has been a comprehensive clinic and hospital offering the complete spectrum for weight loss since last 22 years. A team of well qualified experts at LOC Hospital offer all types of treatments including dietary modification, life style changes, endoscopic treatments like balloon, swallow balloon, bariatric surgery of all types so as to offer optimal weight loss to everyone.

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Bariatric Surgery Weight Loss and Nutrition

Medical Tourism

19/09/2024 13 Comments

13 Reasons Why Thousands of International Patients Choose Dr. Shashank Shah’s Laparo-Obeso Center for Bariatric Surgery in India

  1. Dr. Shashank Shah’s Expertise

With over 32 years of experience and 50,000+ surgeries performed, Dr. Shah is a pioneer in laparoscopic bariatric surgery. He has completed more than 10,000 bariatric procedures and was the first surgeon globally to be awarded the “super surgeon” title. 

His research on surgical treatment for Type 2 diabetes earned him the prestigious Vivian Fonseca Scholar Award from the American Diabetes Association.

  1. Accredited Center of Excellence

Laparo-Obeso Center is the first in the world to be certified as a Centre of Excellence by the Surgical Review Committee of the American Society of Metabolic and Bariatric Surgery. 

The center is also ranked as Pune’s No. 1 single-specialty hospital for bariatric surgery and is NABH accredited, ensuring top-quality and safety standards in all procedures.

  1. Positive Patient Outcomes

Many patients report significant weight loss and improvements in conditions like diabetes and high blood pressure after surgery. Success stories from former patients highlight the center’s ability to deliver lasting, life-changing results.

 

 

 

 

  1. Expertise in High-Risk Cases 

Dr. Shah has successfully handled complex cases, including patients with severe obesity. His expertise in treating high-risk cases has earned him international trust and respect from patients worldwide.

“Padma Shri Dr. D.Y. Patil was operated at the age of 74 with history with history of 5 angioplasties, uncontrolled diabetes (200 unites of insulin everyday)and severe breathlessness. And all the comorbidities were resolves post surgery.”  

  1. Personalized Care

Every patient receives a custom treatment plan based on their health profile. The center focuses on personalized care from pre-operative assessments to post-operative nutrition and recovery, ensuring better weight loss and health outcomes.

  1. Advanced Surgical Techniques

Dr. Shah uses the latest laparoscopic methods, which mean smaller cuts, less pain, faster recovery, and shorter hospital stays. 

These modern techniques reduce the risk of complications, making the experience smoother and more comfortable for patients.

  1. Comprehensive Support

The center offers full support before and after surgery, including nutrition counseling, psychological help, and access to support groups. This holistic care helps patients adjust to lifestyle changes, improving long-term results.

  1. Affordable Costs

Bariatric surgery in India is much more affordable than in many Western countries, typically costing between $3,500 and $6,500. This makes it easier for patients to receive top-quality care without the financial burden.

  1. No Waiting Times

Unlike healthcare systems where patients wait months for elective surgeries, the Laparo-Obeso Center allows patients to schedule their surgery quickly, providing timely care for obesity-related health issues.

  1. Multilingual Team

The center’s staff speaks multiple languages, including English, ensuring international patients can communicate clearly about their treatment and concerns without language barriers.

  1. Supportive Environment

The center is known for its caring and attentive staff. They create a warm, welcoming atmosphere, making patients feel comfortable and supported throughout their treatment.

 

  1. Tourism and Recovery

Patients can combine treatment with exploring India’s rich culture and beautiful scenery. The center often helps patients plan recovery time to enjoy local attractions, making their stay more fulfilling.

  1. Global Recognition

Dr. Shah and the Laparo-Obeso Center are internationally recognized, drawing patients from across the globe. Their excellence in bariatric surgery has been featured by media outlets such as the BBC and National Geographic, highlighting Dr. Shah’s groundbreaking work.

Patients choose the Laparo-Obeso Center not only for its advanced medical care but for the personalized, supportive environment that makes each patient’s journey smoother and more successful

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Weight Loss and Nutrition

Insurance : A Boon For Bariatric Surgery

11/11/2021 No Comments
Insurance For Bariatric Surgery In Pune And Mumbai

‘75% patients received insurance claims in last six months at LOC’
Almost over 200 patients with morbid obesity underwent bariatric surgery at LOC Pune and Mumbai .
Those having a BMI more than 40 or had serious comorbidities like sleep apnoea or heart disease or uncontrolled diabetes could avail insurance cover for their bariatric surgery and the insurance coverage was almost upto 90 percent .

However , there were still a few who were denied claims in spite of qualifying the insurance norms for reasons not known !

Uninsured? Not really! Patients denied claims for weight loss surgery.

Insurance company covers or reimburses all illnesses which are not lifestyle induced. Obesity was earlier thought to be a lifestyle disorder but fortunately in today’s era since October 2020 morbid obesity is accepted as a disease and its treatment is covered under insurance and this will improve better understanding of obesity is a disease and help everyone take further steps for prevention of obesity.

IRDAI has now declared morbid obesity as a disease and included bariatric surgery as an insurance cover since October 2019 which was however, implemented from October 2020. The present criteria for inclusion relates to patients with or in excess of Body Mass Index (BMI) 40kg/m2, those with a BMI of 35kg/m2 with either obesity related cardiomyopathy or coronary heart disease, only coronary heart disease or severe sleep apnea, or uncontrolled diabetes. These four co-morbidities are the only ones in the inclusion criteria of the IRDAI regulations. It is still unknown why only these co-morbidities were chosen. There are co-morbidities like renal failure which are more life threatening but it is unknown why they are not included in the IRDAI guidelines. Obesity does give rise to other co-morbidities like severe joint pain, osteoarthritis, recurrent hernias, polycystic ovarian disease etc. These are not yet included in the bariatric surgery insurance cover even though they are obesity-related co morbidities. It is incongruous to accept that obesity induces osteoarthritis and joint pain yet bariatric surgery is not covered by insurance but joint replacement surgery which could have been prevented is covered by insurance. Any health challenges that can be life-threatening or that make a patient suffer from a disease should be covered by insurance companies.

However, it may probably still take insurance companies some more time to cover all co-morbidities of obesity included under insurance cover. This is Mehta from Ghatkopar Mumbai had a BMI of 47 with severe sleep apnoea breathlessness and had difficulty walking. She underwent bariatric surgery successfully by Dr Shashank Shah however it was Surprising to find that in spite of having a BMI of 47 and all comorbidities her claim was rejected by the insurance company. Mrs Shah from Baramati had the same experience there are many such patients who are still struggling to get their claims in spite of being deserving as per the present guidelines.

Mr. Santhanam from Mumbai, with a BMI of 43kg/m2 underwent bariatric surgery in Mumbai, got the complete insurance reimbursement of 4 lakhs. “I thought Bariatric surgery was under cosmetic treatment and would not get insurance reimbursement but after Dr Shah told me about how it is a disease and how I can get a reimbursement I applied and was pleasantly surprised to have my claim passed.”

Some Facts For The Readers :

Those with corporate insurance do not have any waiting period or exclusion for pre-existing diseases and hence they are more eligible for getting insurance cover for bariatric surgery if they are morbidly obese. Those with individual policies need to have a waiting period with a maximum declared by IRDAI of 48 months to 4 years, so anyone with an insurance cover of more than 4 years is eligible for bariatric surgery in Pune and Mumbai covered if they fall into the criteria declared by IRDAI.

The IRDAI criteria are mandatory for each and every insurance company in the country to follow however documentation of co-morbidities needs to be scientific and backed up by a report from a medical specialist with evidence only then it will be granted. It is important for every individual to know that declaration of their co-morbidities at the time of insurance policy has to be true and authentic and there should not be any exclusion to avoid non-approval of claims in future.

“I believe that this is an excellent initiative by IRDAI and government and it is going to save a lot of costs for the insurance company as well as the society as well as for our country because obesity is known to give rise to multiple comorbidities like heart disease, kidney disease, joint replacement, and recurrent hernia repair surgery in cities like Pune and all these costs, in the long run, can be saved. In fact, even the productivity of an individual would increase if they lose weight in time and increased longevity leads to more productivity,” said Dr. Shashank Shah, pioneer Bariatric Surgeon and the past president of various obesity surgery associations, was one of the first practitioners to push the need of insurance for patients suffering from obesity.
Bariatric surgery is known to improve the overall quality of life, self-esteem, confidence, and the overall performance of a person both in the personal space and in the family or social fabric. The incidences of obesity in India are on the rise and it is more seen in the pediatric age group thereby creating a critical need for our administrative machinery to take every step in preventing obesity and its associated type-2 diabetes in our population; however, those who have unfortunately crossed the stage should get this opportunity to get treated using their insurance cover.

Obesity has been long touted as an expensive disease for treatment since patients incur higher expenses on food, clothing, travel, medication, and treatment of many associated co-morbidities over many years as compared to most other ailments. Therefore, insurance cover has come as a boon for patients seeking bariatric surgery for obesity and its related co-morbidities.

Significance Of LOC Towards Insurance Acceptance

“In last 6 months almost 75% patients undergoing bariatric surgery at Laparo Obeso Centre, LOC Healthcare, Pune have received insurance coverage or reimbursement,” said Dr. Shah, he welcomed this gesture of IRDAI and insurance companies.

LOC Healthcare LLP, known as Laparo Obeso Centre is an Internationally Accredited Centre of Excellence and certified by the Obesity Surgery Society of India as well as International Excellence Federation.

LOC has been one of the pioneer centers in Asia for metabolic and Bariatric surgeries as well as training for Bariatric surgeons.

LOC has successfully treated over 8000 patients with morbid obesity and has three world records in bariatric surgery to the credit.

LOC has made a significant contribution towards Bariatric surgery insurance acceptance.

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About me

Dr Shashank Shah is an expert laparoscopic bariatric i.e. obesity surgeon in India. He is a director of Laparo Obeso Centre which is a centre for treatment for weight loss and weight-related metabolic diseases.

Recent Posts

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