KEYHOLE CURE FOR OBESITY AND DIABETES

More morbidly obese people are turning to bariatric surgery for long term weight loss and a permanent cure for health complications like diabetes

FAQs on Bariatric Surgery

Dr. M. Ramesh, Consultant Lapaprscopic, Bariatric and Metabolic Surgeon, answers some

To the uninitiated, what is Bariatric Surgery? And, what is Metabolic Surgery?

Baros is Greek for weight. Bariatric Surgery is surgery to do away with excess weight. In this surgery, unlike liposuction or cosmetic surgery, we don’t remove and fat from the body. Instead, we resize the stomach by choosing the appropriate technique which results in adequate calorie intake, and over a period of few months the person can lose upto 50 - 75 percent of his excess weight. This is long-lasting, upto a decade or more.

A variant of the same Bariatric Surgery is used to cure patients of uncontrolled Type 2 diabetes, and associated hypertension and high blood cholesterol. This is termed Metabolic Surgery.

Diabetes gets cured too in most people. Does this mean even thin diabetics taking high doses of medication or insulin can benefit too?

Yes. In Type 2 Diabetes, a procedure called Ileal Interposition, or similar procedures can be done without resizing the stomach. This will ensure that insulin resistance by the body is reduced and the insulin production in the body increases. Many do not require any medication, and even if they do, it would be reduced to one or two tablets.

Is Bariatric Surgery safe?
It is absolutely safe. The evolution of modern anaesthesia and advances in surgical instruments and staplers have ensured it becomes a simple 2-4 day hospitalisations and most patients are amazed at how simple the whole experience is. Though this is not a cosmetic surgery, the looks of the patient completely changes once weight loss is achieved.

Process of selection of patients

For the obese: Extensive baseline investigations, psychological evaluation, counselling and preparation for the surgery include a 2 week low calorie diet and breathing exercises.

For diabetics - Based on the Consensus Meet on Metabolic Surgery, criteria have been developed to check if the patient is eligible for the Metabolic Surgery based on some blood test reports.

Routine follow up to ensure that the patients are indeed complying to the diet and exercise regimen is always encouraged. an association of all the patients who have undergone Bariatric Surgery has been formed and has nearly 200 members and is growing by the day.

Observations After Surgery
100 patients were randomly selected 6 months after their surgery. A standard questionnaire with a total of 39 questions was given to each patient to compare the quality of life before and after surgery. These questions evaluated their general health, physical function. Self-esteem, body shape, social environmental change, food intake and overall satisfaction. The patients were classified according to different age groups, sexes and different procedures and results were compared.

Results
It was found that there was a significant improvement in the quality of life post-operatively in each of the groups with no significant adverse effects. However, a few of them would notice an increase in frequency of bowel movements with high intake of sweets. Less than 5% of patients tend to gain some weight within 3-5 years of surgery due to non-compliance of diet and exercise regime.