Questions About Bariatric Surgery And ObesityWe spoke to Dr. Sukhvinder Singh Saggu, a successful bariatric surgeon practising at Apollo Spectra Hospital, Kailash Colony. Read on to discover facts about this speciality. Ques 1. Is anyone with obesity eligible to undergo bariatric surgery?Ans. No, it's not true. We have criteria to perform bariatric surgery. The said criterion is Body Mass Index (BMI). If your Body Mass Index is more than 32.5 with one or two comorbid conditions like diabetes, hypertension, asthma, OSA, infertility, or high cholesterol, then you are eligible for the surgery. And if you don't have a comorbid condition but your BMI is more than 37.5 then you are eligible for bariatric surgery. But nowadays we are doing metabolic surgeries also. In which we do surgeries of those patients with more than 27.5 BMI. So, we can do surgery for uncontrolled diabetes mellitus and other metabolic syndromes. Ques 2. In the last 15 years, the incidence of weight-loss surgeries has risen nearly 100 times. What do you think is the reason behind it?Ans. Yeah, it is true for India. If we talk about 2004, the total number of procedures done in India was close to 200. But in the last year (2018), we did a total of 20,420 procedures in India. So yes the number of procedures has gone up 100 times as compared to 2004. There are various reasons for that. In 2004, the bariatric surgery speciality was just born in India. It was just an infancy period for this speciality. Merely 7-8 surgeons were available to perform the procedures. But now there are around 400-450 experienced bariatric surgeons in India. The number of surgeons has gone up. Additionally, technology has also gone up. The technology we use is better now. For example, we have better staplers. The biggest factor is that we have won the trust of patients as well. Now the patients can trust us more as compared to 2004. Earlier, we were quoting the results from the western countries. But now we are quoting the results from our own country. You have patients from your families. Now when your brother, sister, or uncle go for bariatric surgery, and when you see the results, it is easy to believe in these results. These are a few reasons that have contributed to the increased number of bariatric surgeries. Ques 3. What are the common challenges faced by surgeons in this field?Ans. Some challenges are there in this field as this is a relatively new field. The major thing is that patients do not put their beliefs into this. They think that there are a lot of complications with these surgeries. They are also unable to understand between the complication of the surgery and complications because of obesity. Another challenge is that insurance companies do not consider bariatric surgery as disease treatment. They think that it is a cosmetic surgery, which it is not. It is a surgery to treat obesity. Obesity gives rise to several health problems. So if we treat obesity, we are treating problems like diabetes, hypertension, infertility, back pain, and more. So, in a nutshell, we can say that this is not cosmetic surgery. Insurance companies should come forward and approve bariatric surgery as a treatment modality for obesity. This is already done by the Government of India. Ques 4. Most people, these days, lead a sedentary lifestyle which involves a lack of exercise and unhealthy food habits. How does this affect the process of surgery?Ans. When we do bariatric surgery we usually prepare the patient for every aspect. We counsel the patient that even after surgery, they would have to change their lifestyle and eating habits. Only surgery cannot treat ones obesity completely. One has to supplement it with changes in the manner of living. If the patient is ready to do all these things then only we can do the bariatric surgery. Otherwise only surgery will not work efficiently. So, we encourage the patient to support us and come for the follow-up and change lifestyle habits accordingly. Ques 5. According to the Paediatric Obesity report, there will be approximately 17 million children with obesity in Indian by the year 2025. What would be your message to those children and their guardians?Ans. If we see the data of 2014, nearly 14.4 million children were obese. India, as a country, stands at the second rank in the world after China concerning childhood obesity. China has around 15.3 million obese children. So yes it is expected by 2025 that we would be having 17 million obese children. We need to prevent it because childhood obesity is the root cause of obesity in adulthood. Approximately 22% of children in India, today, are obese which means that every 4th or 5th child is overweight. So if we check obesity in children, we can change the pattern in adults. Children are the future of our country. If we need to improve the future we need to prevent this condition. We should work and make our strategy before the birth of the child, that is, during pregnancy. If a balanced diet is given to the pregnant women then we can prevent childhood obesity largely. Another factor is that if absolute breastfeeding is promoted, this condition can further be prevented. The environment of family, school, and society also needs to be changed. In the family, parents have to be well educated regarding the nutritional value of the food. There should not be free access to junk food, rather access to good playgrounds. Parents should promote domestic work in the house also. So there would be some physical activity for children instead of spending time being inactive in the house. Obesity runs in families as screen time is increasing. Children are sitting on computers, laptops, televisions and mobiles. So if we bring down screen time and increase the game time outside, we can prevent obesity. Ques 6. Obesity is on the rise in India but so are weight-loss surgeries. Do you think these surgeries have become an easy approach for people who do not invest in their health rightly?Ans. Surgery is never an easy approach for anything. Prevention is better than cure. So my message would be to prevent childhood and adult obesity. But yes one option for treatment is bariatric surgery. But going for surgery would not be an easy approach. You would need to make major changes in your lifestyle, eating habits and follow the instructions given by the surgeon. Ques 7. What is the role of technologies in these surgeries?Ans. The present era is not an era for open surgeries. We have advanced technologies to perform complex surgeries. We have already shifted from open to laparoscopic surgeries. And now we are shifting to robotic surgeries. As technology is on the rise, the results of the surgeries are also improving. These new approaches for operations are supported by modern technologies. If we compare the open and laparoscopic surgeries, in the latter the patient has many benefits- they feel less pain, they can easily walk around, the post-operative recovery time is very less, they can join their work within a few days and more. So definitely the technology always plays a better role when we are talking about any kind of surgery. In bariatric surgery, however, technology plays a very major role. For a priority appointment or more information, contact us at +91 8010994994 or book an appointment with Dr. Sukhvinder Singh Saggu here -
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About The DoctorDr. Sukhvinder Singh Saggu is a Senior Consultant- General and GI Surgery and a successful bariatric surgeon practising at Apollo Spectra Hospitals, Kailash Colony, New Delhi. He has an experience of 17 years in these fields. He completed his MBBS from Rajasthan University, Jaipur, India in 2000 and MS - General Surgery from Baba Farid University of Health sciences in 2004.