Obesity, Bariatric and weight loss Myths

Anybody with a BMI of more than 32.5 kg/sq. m can ideally undergo the surgery. Even people with 25 kgs extra weight are suitable candidates & benefit substantially for the management of associated diseases like diabetes, snoring, irregular periods & infertility. If you have Type II Diabetes and it is uncontrolled with medications you may consider the option of metabolic and Bariatric Surgery.
It is not for the weight but for reversal of diseases like Osteoarthritis, Sleep Apnea, Infertility, breast development in young males, Urine incontinence in females with central obesity, recurrent Hernia with obesity, Hiatus Hernia, and Reflux Disease, Varicose Veins, Migraines, and headaches, etc

A surgical weight loss is a useful tool for those who are unable to lose weight due to the diseases of metabolism. It is the only scientifically proven method for long term weight loss in those who have a BMI of more than 32.5kg/m2. It should not be taken as an easy-fix in those who have morbid obesity since no other method of weight loss is known to succeed in these patients.

In our experience of over 7000 patients in a span of 17 years, we find that standardization, advances in infrastructure and equipment, following a safety protocol and guidelines have shown that Bariatric Surgery is as safe as any other routine surgery.
Bariatric surgery is as safe as a hernia surgery with a mortality risk of 0.05% and a re-operation rate of 0.01%. even old adults or those with heart or kidney diseases can benefit from the surgery.

No fat is removed from the body, in fact, the body proportionately converts all fat to energy thus inducing weight loss through various action of Bariatric surgery on the metabolism and body hormones.

Even people with 25 kgs extra weight (BMI > 32.5) are suitable candidates & benefit substantially for management of associated diseases like diabetes, snoring, irregular periods & infertility.

Weight loss surgery is an ideal option for people who have faced repeated failures and physical weakness in attempts to lose weight. It is important to address the root cause; the metabolism and it is important to prevent and treat all health hazards induced by obesity. For those who have crossed a certain grade of obesity and have had multiple unsuccessful attempts it is not the last option but the best option scientifically.

The satisfaction or satiety after every meal, post-surgery, increases considerably. Rather, most of the obese usually avoid eating excessively to avoid further weight gain. In fact, even small portions give the same pleasure as eating a hearty, full meal. However, over the years the amount of food gradually increases and patients do enjoy or have the pleasure of eating like any other normal person. In fact, the patient feels the need to come for a follow-up if they find that themselves enjoying the food in excess.

Morbid obesity is a preventable disease and is one of the major causes of death induced through various associated diseases. It is very well known that the death rate increases with BMI. Obesity is known to reduce immunity and complications of any disease are seen more commonly in these patients. Recent research suggests that obesity can also induce certain cancers. Surgery is done to reduce the risk associated with obesity. Inexperienced hands & evolved bariatric programs, the risk associated with surgery is far less than the disease itself.

Weight loss surgery results in the control of many diseases, improvement in Quality of Life & prolongation of life span too. Nausea may be present in very few patients for a very short duration and can be treated easily with medications.

Post Weight loss surgery, the medicines consumed before surgery for other diseases like diabetes, high BP, irregular periods, etc. can completely stop. However, certain minerals like iron, calcium & B12 may be required as supplements for 1-2 years after sleeve gastrectomy & lifelong after gastric bypass surgery. Most patients need multi-vitamin supplements even without surgery.

The cost of surgery is usually recovered within 1.5 – 2 years due to the reduction in expenditure on associated medical problems besides the benefit from improved quality of life. The cost of surgery is no more than the cost of any other major surgery.

Possibility of weight regain is only 10% compared to over 98% after other weight loss measures like diet, medicines, etc. Minimal weight gain over years happens due to the slowing of metabolism according to aging process. Presently, we have many patients who have followed well and maintained beyond 16 years. It is observed that in spite of some weight regain after a few years of surgery the associated co-morbid conditions remain in remission or in control even after many years.
Weight regain is seen more commonly in those who delay the decision of surgery by many years and their body develops compensatory physiology. Certain people who are Super Obese ie., BMI above 60 may need a second stage surgery after a few years. However, the percentage of such patients is very less. Abuse of any kind may lead to weight regain and should be avoided.

Patients can eat the food of their choice till they are full. This can include fish, chicken, eggs, dal, rotis, rice, etc., just like they would eat otherwise. However, healthier yet tastier choices are explained properly by the nutritionists, and patients find it easy to follow the same after surgery.

The understanding of the altered intestinal system has shown no major changes in terms of digestion & absorption with most of the surgical procedures. Surgical designs similar to Bariatric Surgery have been performed over 200 over for different indications and it is seen that they do not induce major changes in digestion or helping in the survival of an individual.
Science interprets the development of morbid obesity and/or associated diseases as something against nature and when life-threatening it should be altered to a near-natural form.

It is important to look at the impact of obesity on children and they should be treated before it is too late to reverse the damage done by obesity especially where the early onset of diabetes or change in sex hormones is seen.
Elderly patients can also undergo surgery based on their medical fitness decided by our cardiac anesthetists. In fact surgery in the elderly is shown to be as effective and prolongs life as well as improves the quality of life significantly.

Annual follow up may be required for certain mal-absorptive procedures. However, most commonly performed procedures like sleeve require to follow up for 2 years only.

Contrary to this energy levels go up significantly within a short span after surgery due to reduced breathlessness, less joint pains & better nutrition. The utilization of fat as energy gives enough energy for their routine activities and patients, in fact, enjoy this phase of weight loss. The majority of the patients feel more energetic after surgery. This includes even sportsmen.

Sagging of skin only happens in extremely obese patients, patients above the age of 60 years, or those with poor nutrition. The skin can contract well if the patient is young and if excess weight is much less, which means surgery performed in time.
However, there are many more therapies to improve the skin during weight loss and our unit offers all of them to the patients.

After bariatric surgery, the cycles become regular & fertility improves. Pregnancy is to be avoided for 1 year after surgery as it is a period of significant weight loss. In fact, pregnancy after bariatric surgery is known to be safer than pregnancy in the obese for the mother as well as the baby. So far, more than 1000 patients have conceived and delivered normally during our bariatric practice of 17 years.