Due to the COVID-19 pandemic, which caused many people to transition to working from home and engage in less physical activity, obesity has become a severe problem in India. In terms of the number of obese people worldwide, India is currently third, next to the USA and China. According to the National Family Health Survey (NFHS-5), conducted in India between 2019 and 2021, one in every four men or women in India are obese.
Through public awareness efforts and programmes, more people are choosing bariatric surgery (also known as weight-loss surgery). Still, there are significant barriers because of the procedure's social stigma and a lack of awareness in rural areas.
Let us first understand what bariatric surgery is
Bariatric surgery is a weight-loss procedure performed on individuals who are severely obese and have been unable to lose weight through lifestyle modifications such as diet, exercise, and supplements. This is one of the best alternative techniques now increasingly practised is a weight-loss balloon, which doesn't require surgery or endoscopy and guarantees a 10 15 per cent loss in Total Body Weight (TBW). Bariatric surgery involves changing the digestive system to limit food intake or reduce nutrient absorption, resulting in weight loss.
While it can have significant benefits for obese adults, it also carries certain risks. Let's explore both the benefits and associated risks of bariatric surgery.
Substantial Weight Loss: Bariatric surgery can lead to significant and sustained weight loss, reducing Excess Body Weight (EBW) by 70% or more.
Long-Term Weight Maintenance: Weight loss surgery offers a better chance of long-term weight maintenance than traditional methods. It can help individuals follow new eating habits and promote a healthier lifestyle, leading to sustained weight loss.
Improvement of Obesity-Related Health Conditions: Bariatric surgery can positively affect obesity-related health conditions mainly high blood pressure and cholesterol, type 2 diabetes, sleep apnoea and even cancer. Many patients experience improvement or even complete resolution of these conditions after surgery.
Faster Metabolism: It becomes easier to exercise as the weight is lost. Exercise enhances your body's capacity to burn fat effectively. Examples of such activities include biking, walking, and swimming. Additionally, reduced levels of stress hormones like cortisol and insulin also lessen the body's tendency to store fat.
Enhanced Quality of Life: Weight loss can improve an individual's quality of life by boosting self-esteem, mobility, and overall well-being. One may feel a positive change in their energy levels and mental health.
Longer Life Span: Weight loss surgery has been shown to significantly improve life expectancy by over 40 per cent.
Associated Risks of Bariatric Surgery for Adults
Though this procedure comes with a lot of benefits, yet some risks remain. Let us take a look at those risks.
Surgical Risks: Like any surgical procedure, there can be risks associated with anaesthesia, bleeding, infection, and other potential complications. However, bariatric surgeries are generally considered safe, and the risk of severe complications is relatively low.
Nutritional Deficiencies: Certain types of bariatric surgery, such as gastric bypass, can affect the absorption of nutrients, including vitamins and minerals. Patients may need to take lifelong supplements and undergo regular monitoring to prevent deficiencies.
Gallstones: Rapid weight loss and changes in bile acids can increase the risk of developing gallstones. This is especially common after the first two years of surgery and, in some cases, may require gallbladder removal as well.
Anaemia: The duodenum is the initial portion of the small intestine where most of the iron from foods like beans, meats, and iron-fortified grains is absorbed. But following a gastric bypass operation, the duodenum is not used to process food. Hence, the risk of anaemia may increase, specifically following a Roux-en-Y gastric bypass (RYGB) procedure.
It's important to note that the benefits and risks of bariatric surgery can vary depending on the individual's health, the specific type of surgery, and the surgical team's expertise. Consultation with the doctor for the benefits and risks is vital for making an informed decision and achieving long-term success.
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(This article is authored by Dr Aman Priya Khanna, Co-Founder HexaHealth and General, Laser, Bariatric and Minimal Access Surgeon)