Q: Does the surgery leave scars? Does itrequire any kind of cosmetic treatmentafter surgery?

A: It leaves puncture marks, which are notvery prominent. Sometimes, after afat per-son loses weight, the abdominal skin sags. Inthis case, plastic surgery is done to remove

the excess skin.

'Morbid obefity if 0deodfy dheofe',

BESITY HAS become a majorhealth problem' today, in fact it hasacquired epidemic proportions,thanks to changing lifestyles. Forthe uninitiated obesity means prob-lems related to excess body weight

ranging from mild Dverweight to the morbidlyobese. Efforts to treat morbid obesity through con-trolled diets, behavior modification and exerciseprograms which work very effectively in mildlyobese people, are only temporarily successful withpeople who suffer from morbid obesity. So, obesitysurgery is the only method by which long-termweight loss can be achieved in morbidly obese peo-ple. Seven to nine per cent people in India are over-weight, of which 20 - 25% are morbidly obesewhich amounts to a staggering 2 - 2.5 millionpeople. Padamshri Dr Pradeep Chowbey, chair-man, department of minimal access surgery, SirGanga Ram Hospital, New Delhi, is one of the

first to periormthe laparoscopic cholecystectomyin North India. He hds also pelJormed over a 100successful obesity surgeries. Here he talks toGunian Sharma about various issues related toobesity and obesity surgery, known as Bariatricsurgery in medical terms.

Q: What exact.Jyis morbid obesity?A: Morbid obesity is a condition in which the

Body Mass Index (BMI) of a person exceeds 40.Morbid obesity is a disease that leads to a num-ber of deadly diseases like diabetes (Type 2),cardiac disorders, gallstones, high blood pres-sure, arthritis and even cancer. Unlike over-weight, which can be managed by altering thelifestyle, morbid obesity needs treatment likeany other disease. Now with the help ofBariatric surgery , we can successfully treatmorbid obesity.

Q: What is Bariatric surgery?A: Bariatric surgery is fat reducing surgery

that helps you to lose weight by altering yourbody food digestion and absorption procedure.It is a minimal access surgery which can nowalso be done laproscopically. There are twomodes in which this surgery can be done one isgastric banding in which a silicon band is

- placed around the uppermost part of the stom-ach making a small pouch. The second way isgastric bypass, in which a part of the stomach isstapled or divided to a small pouch. Then a longportion of intestine is attached to the stomach

to divert food content and stomach juices. Boththe procedures shorten the stomach due towhich a patient feels full faster.

Q: Doesn't restricting one's food intakereduce the general health and immunity oftile person?

DR PRADEEP CHOWBEY

A: The less the body weight, the more is the per-son's power to fight with the disease. Fat is animmuno-suppressant. In this' surgery, a personloses approximately one to two kilograms ofweight every week till he attains the requiredweight and a healthy body.

Q: How is this surgery different fromother fat reducing surgeries such as lipo-suction?

A: Liposuction is a cosmetic surgery,which is used to remove the excessive fatfrom a particular part of the body to give ita cosmetically acceptable look. The weightloss is temporary in such procedures.However, Bariatric surgery is a life savingsurgery, which reduces weight from allover the body and the weight loss is per-manent.

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Q: How much does it cost?A: Around Rs 50,000 to Rs 2.5 lakhs.

Q: What precautions does a patienthave to take after the surgery?

A: The surgery does not have any sideeffects. It needs hospitalization for 24 to 48hours and a patient can resume his or herwork within a few days after the surgery.But a patient has to keep a constant watchon the calorie intake and the quality of foodhe eats. A person has to follow a regularexercise regimen to stay fit.

Q: Do you think people in our countryare aware about this surgery?

A: Though the surgery is being performedfor over four years, very few people areaware of it. People don't know that theyhave a permanent solution for morbid obe-sity that threatens their life.

Q: When can the obesity be best man-aged or controlled?

A: In a survey conducted in public schools,we found that 30 percent of the school chil-dren are obese. And the reasons for this obe-sity are unhealthy eating habits and a seden-tary lifestyle. Obesity can be best managed atthis level. For it, children should be encour-aged to take up physical activities, should eata balanced diet and participate in outdoorgames.

Q: Is the surgery the only option for tilemorbidly obese people?

A: Yes. It is because the patients with mor-bid obesity do not respond to medical meansof weight loss. Efforts to treat morbid obesitythrough controlled diets, behaviour modifi-cation and exercise programs are only tem-porarily successful. Morbid obeft.ity is a dead-ly disease that needs immediate surgicaltreatment. •