Get Waisted

Dr Pradeep Chowbey, head of minimal invasive surgery at Ganga Ram Hospital, New Delhi. Last fortnight, he performed a laparoscopic gastric bypass surgery on a 40-year-old weighing 181 kg.

How does it work?
Stomach stapling works by restricting the amount of food one can eat at a time. If the size of the stomach is such that it can accommodate only four or five tablespoons of chewed food, it certainly makes the person feel full more quickly. ‘‘Post-surgery, the patient feels full after eating only 30 per cent of what he ate earlier,’’ says Chowbey. Since the calorie intake is reduced, the body is forced to burn up stored fat, forcing weight loss.

What does the surgery involve?
The first step is to divide the stomach into a small upper section and a larger bottom section using staples (similar to stitches). The top pouch will hold the food the patient eats. Then a section of the small intestine is connected to the pouch (by a ‘roux limb’), allowing the food to travel to the remaining portion of the small intestines, forming a Y-shape. This Y-connection allows food to mix with pancreatic fluid and bile, aiding the absorption of vitamins and minerals. Absorption of certain nutrients, though, may be inhibited.

What are the long-term fallouts?
While precise success rates for stapling are not known, patients can expect to lose 50 to 60 per cent of their excess weight after surgery. However to keep weight off in the long term, patients have to consciously work on keeping their food intake low and maintaining a strict exercise schedule. Long-term weight regain is common, especially if post-op dietary and workout guidelines are flouted.

Who qualifies for surgery?
‘‘Bariatric surgery is an option in case of morbid obesity,’’ says Chowbey. A person has to be 40 kg over his ideal weight and have a Body Mass Index of 40, for doctors to even consider the surgery. Since this is not a cosmetic procedure, a thorough physical and psychological evaluation is mandatory. This will determine if the body can support the surgery and whether the person is ready to adhere to a healthier lifestyle. Doctors make it clear the success of the surgery is dependent on lifestyle changes. The patient also receives exhaustive nutritional counselling before (and after) surgery.