The 'Big Fat' problem: Why Indians should shun hesitancy to treat Obesity

Hyderabad: Obesity has become a major health crisis in India. The prevalence has increased in the last three decades. As per the reports of the World Health Organisation (WHO), obesity is responsible for 44% of diabetes, 23% of heart disease, and 4-41% of cancer cases across the globe.

However, despite the availability of treatments in India, the lack of awareness and stigma are preventing people from consulting doctors.

Given the fact that obesity is known as the mother of all diseases, doctors advise people to go for surgery for obesity.

Obesity and overweight as per BMI

The Body Mass Index (BMI) is checked to determine if a patient is normal, underweight, overweight, or obese. Those with BMI between 18 and 24 are considered normal and 25 to 30 are considered overweight.

Dr Vimalakar Reddy Eppa, HOD and senior consultant, Gastroenterologist, and Bariatric surgeon at KIMS-Sunshine Hospitals, Begumpet said, “Those with BMI above 32.5 with comorbidities and with BMI higher than 37.5 without comorbidities are considered eligible for surgery”.

Types of surgeries

The types of bariatric surgeries are divided into three types namely, restrictive, malabsorptive, and the combination of these two.

“Laparoscopic sleeve gastrectomy is the most common restrictive process carried out where 70 to 80% of the stomach is removed. The portion of the stomach that produces ghrelin. This helps the patient feel full and not hungry”, Dr Vimalakar said.

The ghrelin hormones are responsible for sending hunger signals to the brain. When the portion generating ghrelin is removed, the brain does not receive any signal of hungriness and thus reduces appetite.

“In malabsorptive procedure, a portion of the small intestine is bypassed and hence the amount of nutrition absorbed by the body gets reduced. There is no need for restricting food intake in this type of treatment”, Dr Vimalakar added.

MGB and RYGB for weight loss

The two commonly followed surgical procedures for obesity under the malabsorptive treatment are Mini Gastric Bypass (MGB) and Roux-en-Y Gastric Bypass (RYGB). Studies have proved that these surgeries have drastic improvements in quality of life.

“In MGB the amount of food consumed is reduced while in RYGB the amount of absorption is reduced. In both the procedures, the body weight is reduced either due to lower food consumption or due to lower absorption of nutrition”, Dr Vimalakar said.

Benefits of bariatric surgeries

Despite the high prevalence of obesity and overweight, several people are averse to undergoing treatment, either due to stigma or lack of awareness.

“Most people confuse this treatment with that of liposuction where fat from different parts of the body is removed. The bariatric surgeries alter the metabolism of the individual and hence are known as metabolic surgeries”, Dr Vimalakar added.

The major benefits of the treatment include a reduction in weight, hypertension, type 2 diabetes, chances of cancer and heart problems, obstructive sleep, and an increase in fertility.

“Through the treatment, we are treating both the existing medical problems and preventing the future possible problems that could arise due to obesity. Since these surgeries are scientifically designed, people must come forward to undergo the treatment for a better quality of life”, Dr. Vimalakar emphasized.