Bariatric surgery is the only proven effective weight loss method for long-term weight loss. There is no other method which offers sustained weight loss in the long run.

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This is the view of Hyderabad's leading bariatric surgeon, Dr Nandakishore Dukkipati, Obesity & Diabetes Surgery Clinical Director and Chief Surgeon.

Bariatric surgery can improve the quality of life and also longevity of the person with obesity. According to him, these procedures are not just life-altering but they are also life-saving. Excerpts from an interview:

IANS: What is wrong with the Indian diet? Does it predispose us to obesity?

Dr Dukkipati: The Indian diet predominantly is carbohydrate-rich compared to the Western diet, which is high in protein. Due to high carbohydrate intake, oily foods, fried foods, etc, people tend to become more obese in India. This particular diet is also high in glycaemic index, which also makes people diabetic and suffers from other health conditions.

IANS: How big is the epidemic of obesity in India? Why is it getting bigger?

Dr DukkipatI: It is an ever-growing problem. Right now, overweight/obesity in India is about 9 per cent to 12 per cent, depending on which geographical area you look into. It's more in urban areas and also higher in women.

It is progressively becoming bigger because of the increased amount of disposable income, changing lifestyles, people are more into the internet, social media and desk-based jobs, BPOs and working in irregular time schedules servicing the clientele from the USA, and Australia. So, their sleep cycle is disturbed.

Also, if you look at the younger generation, the concept of playing outdoor sports, etc, has come down quite a bit. Many are into video games, social media, watching TV shows, movies, and other such sedentary activities.

Hence, lack of physical activity and consumption of high-calorie food material, junk food, and fast food, all these things are predisposing people to gain weight and the problem of obesity is multiplying in India year by year.

IANS: How does obesity impact lifestyle diseases?

Dr DukkipatI: Obesity is the main source of many ailments. It can lead to Type II diabetes, hypertension, and high cholesterol levels and can result in brain stroke, heart disease, and certain cancers. These are the big complications. Also, people with obesity suffer from shortness of breath when they walk or climb stairs, and people snore at night, which is called Obesity Hypoventilation Syndrome.

They also suffer from gout, varicose veins, and joint pains, especially in weight-bearing joints such as knee joints and lower back. Younger women suffer from PCOD and infertility. Also, fatty liver is another bigger issue. All these conditions are a result of obesity and these impact lifestyle diseases.

IANS: Did the COVID pandemic add to the problem of obesity?

Dr Dukkipati: COVID has only made obesity worse in India. For a period of two years, most of the people were in house arrest mode. There was a lack of physical activity. Increased food consumption, people addicted to being online, watching movies, etc, and staying at home without any physical activity have led to an exponential increase in obesity and overweight in the population.

COVID also made things worse by increasing physical complications either directly by COVID infection or indirectly by situations like long COVID where people have joint pains, post-viral syndrome, weakness and some people are prone to blood clots which are leading to heart attacks among the younger population, causing brain strokes, heart attacks, and so on, at a younger age. All these are resultant of post-COVID effects, and this has made things more complicated.

What is your view about fad diets? What works? What doesn’t?

Dr Dukkipati: As the name goes, fad diets are just fad diets. They are there today. They will be there for some time. Every few months, you will have special diets coming out depending on what the promoters believe in and what they are promoting.

For the most part, any properly designed diet is good for weight loss, and it will also help in improving health conditions. Having said that, most of these diets are difficult to follow for the rest of a person’s life.

Whether it is a Keto diet or a diet free of salt, avoiding completely high-calorie material or oily food material. These are not practical over the course of time. For the short time, short intervals and short-term weight loss, most of the fad diets are okay, but for long-term weight loss and to maintain that weight loss, these fad diets fall short significantly.

IANS: What are the new developments in the fight against obesity? How efficacious do the new treatments promise to be?

Dr Dukkipati: There are many newer developments in the fight against obesity. The baseline remains the same, which is lifestyle modification, physical activity, consuming an appropriate diet, following the glycaemic index, and making sure high-calorie intake does not happen. These are basic rules.

However, to manage obesity there are some new molecules and medications that have come in which are offering a decent amount of weight loss, while the person continues to be on those medications. Unfortunately, when these medications get discontinued, we do see some amount of weight regain.

Bariatric surgeries are also there for those people who are morbidly obese. Bariatric surgeries are not cosmetic procedures. It should not be considered for people who are just a few kilos overweight. But if someone is at least 20 kg more excess in weight than their ideal body weight, they can definitely consider bariatric surgery.

There are newer endoscopic methods like gastric balloons and endoscopic sleeve gastroplasty, and many such methods have come into play, which are also offering fairly good results

IANS: How effective is Bariatric surgery? What are the risks? Are the risks underplayed?

Dr Dukkipati: Bariatric surgery is the only proven effective weight loss method for long-term weight loss. There is no other method that offers sustained weight loss in the long run.

Bariatric surgeries today have become extremely safe due to advanced technology and the latest developments and increased surgeon’s experience and exposure and also increased patient compliance to the guidelines before and after surgeries.

On average, literature shows that bariatric surgeries are safer than routinely performed gall bladder surgeries with a risk of 0.5 per cent.

The perception that the risks are often underplayed is a general notion and myth. Bariatric surgery, especially being a relatively novel option for controlling morbid obesity and type II diabetes etc, the data reporting is very stringent.

As it is, any complication or any adverse outcome has always been at the centre point of media attraction. Most educated and well-versed surgeons always inform their patients and update them about potential complications and risks of bariatric surgery.

This is called acceptable risk because a patient's health conditions because of obesity and other ailments make the quality of their life very poor and also their longevity very lesser.

So, with bariatric surgery, we can definitely improve the quality of life and longevity of the person. In general, people tend to be very happy once they have lost all the excess weight.

In short, bariatric surgeries are quite safe and effective. These procedures are not just life-altering, but they are also life-saving.