Fats in the fire

The death of a man in Gujarat following a weight loss procedure has highlighted that more obese people are resorting to surgery...

Weighing in at 160 kg,25-year-old Kinnar Patel wanted to lose 100 kg. And he wanted to do it fast. Like an increasing number of people in Gujarat,he opted to go in for weight loss surgery. Instead,he lost his life.

Obesity experts say that,like Kinnar,more and more people are turning to surgery to lose weight. While surgeons in the state see a higher percentage of women patients,an increasing number of overweight men are also opting for surgery. And while this trend was more or less confined to a younger age group until recently,this is not the case any longer.

Gujarat reportedly was the first state in the country with a weight loss surgical centre offering nearly 10 different procedures. Upon the advice of his surgeon,Dr Mahendra Narwaria,Kinnar decided to go in for a sleeve gastrectomy,which is relatively non-invasive and uses laparoscopic bariatric techniques.

Narwaria,who has conducted about 400 such procedures,believes that diet,exercise,and medicines are not enough to cure obesity and that in extreme cases,surgery is the best option. In laparoscopic methods,variants like multiple puncture,single puncture are common. But rare methods like natural orifice surgery whereby fat is removed from the vagina,rectum,bladder etc. are also used.

Obesity is a lifelong disease if not treated, Dr Narwaria said. Those who have a Body Mass Index BMI of 26 or more are severely obese while those with 37.5 and above fall under the morbidly obese category. Today obesity is the root cause of hypertension,blood pressure,heart risks,diabetes and infertility. People with obesity also suffer from sleep apnoea,depression and gastric troubles.

According to experts,gastric procedures are highly in demand here,as Indians commonly have belly fat problems. Procedures like gastric banding,sleeve gastrectomy,gastric bypass and duodenal switch see box that are malabsorptive methods are commonly advised.

In Kinnars case,the sleeve gastrectomy procedure involved the stapling method for appetite suppression. Dr Narwaria who operated on him explained,The stomach is dissected in the shape of a banana and a certain portion is removed. As a result of this,patients can only consume 800 to 1000 calories a day.

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But this seemingly simple procedure backfired for Kinnar,who also suffered from hypertension. At the scale of 150 kg and above,the arteries and veins become fragile. Without any symptoms,Kinnar got a heart attack. He even took a walk in the hospitals lobby after his operation, said Narwaria,who gets nearly 150 to 200 patients per month in his hospital.

Apart from these surgeries,liposuction is another popular way to get rid of fat quickly. Cosmetic surgeon Dr Devesh Patel maintains that liposuction is much in demand in Gujarat but has some limitations. Cosmetic surgery can treat only concentrated fat lying in certain areas of the body. One liposuction session can remove nearly 6 to 7 litres of fat. This is a physiological method that doesnt disturb internal system of a person. Liposuction can be used for people who have a BMI up to 30. Those with a higher BMI are advised to go in for weight loss surgeries, he said.

He added that liposuction includes a variety of procedures like laser,machine,ultrasound and syringe liposuctions. The only complication that can arise,he said,is fat embolism,which leads to excess fat storage in a particular vessel in the body. However,a survey by the American Society of Plastic Surgeons found one in every 5,000 liposuction procedures in 1994-1999 led to death.

But newer techniques are also being adopted,including Vaser lipoplasty that utilises an ultrasound and the Sils Port that involves removal of fat from the navel.