With life style changes, economic growth and rising disposable incomes, obesity among Indian population is rising alarmingly and reaching epidemic proportions. However, the nation requires more qualified surgeons and treatment facilities to overcome the problem, according to Dr.Muffazal Lakdawala, Founder and Chief Surgeon – Digestive Health Institute by Dr. Muffi in an interview to Sreekumar Raghavan of Corporate Ethos.
Dr Lakdwala had gained global attention following the surgery he conducted on Emaan Ahmad, the world’s heaviest woman,having arranged for her travel from Alexandria, Egypt to Saifee hospital in Mumbai. Under his care, her weight was reduced from 500 kg to 176 kg.
Dr Muffazal Lakdawala, is the Chairman of Institute of Minimal Access Surgical Sciences and Research Center, Saifee Hospital and Founder of Centre for Obesity and Digestive Srugery, the first Indian Centre for Excellence in Bariatric Surgery.
A trained laparoscopic surgeon, he specialises in bariatric and GI oncology surgery and known globally for his work on scarless bariatric surgery. He won the Lokmat Maharashtrian of the Year 2017 Award and is the author of the best seller The Eat-Right Prescription published in 2016.
Excerpts from the interview:
1) In your view what are the reasons for the increase in obesity and life style diseases. Are Indians more pre-disposed to such diseases due to our eating habits or life style?
Ans: Obesity is on a rise and is reaching epidemic proportions. The number of overweight and obese people in India has doubled between 2005 and 2015. This alarming rise can be mainly attributed to the bad eating habits, stress and an unhealthy lifestyle wherein there is minimal physical activity accompanied by a consumption of high fat and sugar foods regularly. Indians, as such are more prone to visceral or truncal obesity which can lead to metabolic syndrome (diabetes, hypertension, cholesterol) fatty liver, gout, predispose the youth to infertility and a myriad of different types of cancers. It also leads to low self-esteem, lesser job opportunities or promotions and more work hours lost due to illness.
2) What are the goals and objectives of bariatric surgery. What type of patients are usually advised to undergo bariatric surgery and what is the success rate?
Ans: Bariatric surgery is a surgery performed on the morbidly obese people to help them get rid of their life-threatening illnesses and in turn improve their quality of life and is in no way a cosmetic surgery. The goal of Bariatric Surgery is to treat or control medical conditions which are usually associated with Obesity such as Diabetes Mellitus, Hypertension, Osteoarthritis, Hyperlipidemia, Obstructive Sleep Apnea with minimal side effects or threat to life. The current guidelines classify people based on their BMI as candidates for surgery. A BMI above 37.5 or a BMI above 32.5 with Diabetes or sleep apnea or other comorbid conditions makes you a candidate for surgery. Success rates after bariatric surgery vary from procedure to procedure and patient to patient and depend on the follow-up and lifestyle changes the patient is ready to adopt after surgery. The most common bariatric procedures performed in India today are the Sleeve Gastrectomy, Gastric bypass or the Mini gastric bypass. Bariatric surgery is the only proven method today at achieving long-term sustained weight-loss for the morbidly obese people.
3) Are women more prone to obesity than men in general?
Ans: Not necessarily true. Women are more prone to subcutaneous fatty deposits “Pear-shaped obesity” whereas men are prone to visceral obesity “Apple-shaped obesity” which is more dangerous. In women, hormones, PCOD, pregnancy and menopause all can contribute to obesity.
4) How would you assess the rising demand for bariatric surgery and growth of treatment facilities in India?
Ans: With the growth of obesity and it’s negative health impacts, people in India are looking for solutions to long-term weight loss but have few answers with non-surgical solutions hence the growing need for bariatric surgery. Also, a lot of people from different walks of life have achieved good results with Bariatric surgery and a few celebrities have even spoken positively about it. This has led to the rising demand or bariatric surgery. Also, more surgeons have trained in bariatric surgery and centres of excellence for bariatric surgery are growing in number.
5) What are the costs involved in bariatric surgery, hospital stay required and post-operative recovery phase?
Ans: Costs involved for bariatric surgery vary from the procedure being performed and the hospital where it is performed. The average cost is 2.75 lacs to 3.5 lacs and above. The average length of hospital stay is usually for 2 nights and the patient is usually fit to go home by the first post-operative day unless the patient has other severe illnesses. Patients have lesser pain with the single incision approach, a procedure that we practice at Digestive Health Institute. Most people can resume work within a few days.
6) For those who have undergone bariatric surgery, what kind of lifestyle changes have to be adopted to retain their shape and fitness?
Ans: Bariatric surgery leads to a significant sustained weight loss but maintaining that weight loss is the key to having a good quality of life. Diet and behavioural modifications, regular exercise remain the cornerstones of success after bariatric surgery.