Dr. Biswanath Gouda is an Advanced Laparoscopic GI & HPB Surgeon, well trained in the US and Paris. His research includes bariatric treatment for morbidly obese patients & treatment modalities for liver and pancreatic cancer through laparoscopic surgeries. He’s been practising in Mumbai since 12 years and is the only surgeon in Bandra to perform this surgery. Bariatric surgery is proving to help obese people alleviate or reduce their diabetes, control blood pressure and improve fertility among women. Here’s what the expert has to say.

What is bariatric surgery?
Bariatric surgery is performed to treat metabolic disorders. It is also called metabolic surgery or weight-loss surgery. The most commonly performed bariatric surgery in India is sleeve gastrectomy. In sleeve gastrectomy the stomach is reduced to the size of a banana. This is performed through a laparoscopic surgery. Other types of laparoscopic surgeries are Gastric Bypass and Mini Gastric Bypass.

How helpful is Bariatric surgery to obese patients?
Bariatric surgery is weight-loss surgery where patients lose their excess body weight over a period of 12 to 16 months. It also helps them normalize their blood sugar, blood pressure, blood cholesterol and other ailments.

Is bariatric surgery cost effective?
Yes, it is cost effective. People think that weight-loss surgeries can be afforded only by the rich. That’s not true. These surgeries are available at affordable prices as well. It ranges between 2.5 to 4 lakh. The cost is high due to the use of surgical staplers. However, there are financial entities that offer financial support based on your income.

What is the right age to undergo bariatric surgery?
Anyone between 20 and 70 years of age could undergo this surgery. I personally feel, people over 70 should not go in for this and for those below 20 should focus on dietary measures and exercise before deciding for a surgical arrangement as they are still young.

How long does the surgery last for?
The surgery is done in an average of two hours while the average hospital stay for a patient is two days. In case of risk factors, the patient is kept under observation for 24 hours in the ICU.

How much weight-loss can one expect through these surgeries?
It’s purely mathematical. If you are 100 kilos, your ideal body weight should be 60 kilos. So, you are 40 kilos overweight. Out of which you begin to lose 80%, that is, 30-32 kilos in the first one year. Basically, you lose 80% – 90% of your excess weight through bariatric surgery.

Is this surgery gender relative?
70% of the patients who undergo bariatric surgery are females.

Is obesity related to PCOD? What causes PCOD among teenagers?
PCOD is caused by hormonal imbalance, adiposity and insulin resistance. You’ll observe that most obese patients become diabetic. The fat cells of their body increases which reduces the insulin production. This is beneficial to females who suffer from PCOD or PCOS as their hormonal level is improved, thus improving their fertility rate.

Does bariatric surgery have any side effects?
There are no side effects as such. We check the functionality of heart, lungs and kidneys. If the patient is of high risk, only then they are kept in the ICU. This type of surgery should be done in a hospital with all amenities and by a bariatric team.

How is bariatric surgery different from liposuction?
In liposuction, we only suck out the fat cells. You lose fat as per your requirement. But this is only temporary. The fat grows back after 6 months and the situation is the same. Bariatric surgery, on the other hand, is purely surgical and metabolic, with the use of laparoscopic instruments, which normalizes your blood sugar, blood pressure and cholesterol, leads to a more permanent solution and improves the quality of life.

What is Laparoscopic surgery in simple terms?
In layman’s term, laproscope is understood as laser or minimal invasive surgery. We do not cut open the abdomen to operate, instead make small cuts and slide instruments with minute cameras, through these cuts. The magnified image onscreen helps to perform the surgery smoothly. The pain after surgery and complications are less and the patient recovers faster.

Why are some obese patients still reluctant to undergo bariatric surgery?
Firstly, people are reluctant because of the myths that are reinforced. Out of 1000, the rate of fatal complications is around 1, which is extremely low when done at appropriate centres. But people still focus on the downside which reinforces fear. It should be understood that bariatric is not a risky surgery. Secondly, people do not reveal the fact that they have undergone a bariatric surgery because of the stigma attached to it.

What precautionary measures should patients maintain after the surgery?
Bariatric surgery is a tool that helps you regain life. Once they start losing weight after the surgery, exercise is equally important with a well regulated dietary habit to keep oneself toned. The whole concept of bariatric surgery is based on diet. If you can’t control your diet, you shouldn’t opt for the surgery as your first option. We put the patients on a low calorie and high protein diet and prescribe them calcium and vitamin tablets. In fact, calcium and vitamin supplements should be taken by all people once they cross the age of 40.

Why is it important to take calcium and vitamin supplements?
It is a misconception that you meet all your requirements through food. That’s not true. A glass of milk is helpful only till 8 or 12 years of age. After which, your body doesn’t digest it. To procure the suggested calcium amounts, you would have to consume 20 liters of milk per day. As an alternative, calcium & vitamin supplements are important.

Should an obese person use the gym?
Someone who his extremely overweight should not join the gym or run the treadmill because that leads to higher risks of trauma or cardiac arrest. Instead they can try plain walking, yoga or swimming.

One advice to the parents who are worried about their child’s food habits.
In a fast paced generation, there’s no time for home food. With both parents working, children find it convenient to binge on fast food. These things should be avoided. Try sticking to home food as much as you can. Gadgets have made lifestyle very sedentary. Obesity has become an epidemic. The best way to prevent it is if kids play out every evening. In this way, we can aim at a healthier tomorrow.

Gouda Clinic, 11, Geetanjali, near Apollo Pharmacy, S.V. Road, Bandra (W)
Contact: 26418641 / 26418642

Sharlene Lobo