4-year-old boy youngest ever to undergo bariatric surgery

Rishi Khatau never looked his age, thanks to the extra kilos of fat that the small boy carried around him. The 4 years and 10 month old weighed 44.5 kg and would consume 1,400 calories a day owing to a rare genetic disorder that made him extra hungry and consequently pile up the pounds.

Ironically, Rishi was born underweight at 1.8 kg in 2008 in a Kutchi Gujarati family in Kolkata. His weight was normal till he was one and half years. After which it started increasing abnormally.

Ultimately, his son's abnormal growth led his father, a Kolkata-based businessman to approach Dr Mahendra Narwaria, a bariatric surgeon for help. He underwent a bariatric surgery at a city-based hospital to help manage his condition. Doctors, who operated on Rishi, claim that he is the youngest patient in the world to have undergone the weight-loss surgery.

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What brought the family to Ahmedabad was Rishi's suffering from Sleep Apnea, a condition in which the patient forgets to breathe while he sleeps leading to lack of oxygen. Dr Narwaria said it was a result of his obesity. (Also read: Bariatric surgery: Does it help you lose weight? (Expert Speak))

'The child suffers from a rare genetic disorder called Prader Willi Syndrome in which a deletion or disruption of genes made the patient have less muscle tone, reduced activity, a tendency to put on weight and chronic hunger. His obesity was leading to Sleep Apnea resulting in the child not being able to sleep for more than 10 minutes waking up gasping for breath,' said Dr Narwaria.

He said that usually such surgeries are not carried out on children so young but in this case there was no other option. 'Exercise and controlling diet was not an option as due to his weight, he could not exercise while his genetic condition made him crave for food.'

The doctor and his team following the surgery have reduced Rishi's stomach to one-third of its size. 'His stomach will grow to its normal size as he grows up,' said Dr Narwaria. The child will now be able to consume just 400 calories a day. He is expected to lose 60% to 80% of its weight. At present, the child is on a liquid diet and will then be moved to mashed food before being able to have the normal food.

Dr Ramen Goel, a bariatric surgeon tells us more about the procedure.

It isn t a shortcut to weight loss

People who believe that it is a short cut for weight loss are generally not the ones who need it. This is for people who have honestly tried to lose weight and tried various gyms, diets, have gone and have lost weight which keeps coming back.

Typically, bariatric surgery is advised for those patients who are at least 25 to 30 kilos overweight with BMI 32.5 or above. People with severe diabetes, hypertension or obstructive sleep apnoea associated with obesity are also likely candidates. Women who have irregular periods and are unable to conceive due to obesity can also opt for the surgery.

Bariatric surgery can be performed on all kinds of patients except if they have an unstable heart condition or untreated angina, or are psychologically unstable in which case they don t understand/appreciate what is required after bariatric surgery and will not follow-up.

It is not purely a cosmetic procedure

According to Dr Goel, a renowned bariatric surgeon, Bariatric surgery is a sort of a last resort surgery. I get patients who are well into their 60 s, who undergo bariatric surgery so that they can regain their quality of life. A person, who is obese or morbidly obese, finds it difficult to perform even the simplest of tasks. He/she is unable to walk on their own to the bathroom because of severe knee pain, they may be unable to drive a car, or cook. There are patients who cannot sleep due to severe sleep apnoea (a condition that leads to suffocation and loud snoring). I find it laughable that the IRDA would say that such people would undergo this surgery for the cosmetic factor. Almost 80% of my patients are beyond the age where looks would matter, it is their functionality that matters to them. (Read more: Is Bariatric surgery really a cosmetic procedure?)

With inputs from DNA

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