Morbidly obese persons with conditions like diabetes who undergo bariatric surgery have a good chance of losing their diabetes post-surgery, experts said here today.
Bariatric surgery involves removing 80 per cent of the stomach, banding, or bypassing it, thus reducing its capacity and restoring the patient to normal hunger pangs, according to Apollo Hospital's head of bariatric surgery P.K. Reddy. Obesity is a clinical condition that has a clearly established link with increased risk of Type 2 diabetes, hypertension and heart disease. It has been proved that obesity surgery can cure metabolic complications, including diabetes, he added.
One of his patients, Gautam, who had his surgery done 10 months ago, shared his “life-changing experience.” Weighing at 163 kg before the surgery, he has now whittled down to 90 kg. “My diabetes, BP and gout have all disappeared completely after the surgery,” he said.
“Patients get out of diabetes within weeks after the surgery,” added Torsten Olbers, Swedish expert on bariatric surgery, currently senior consultant with Imperial College, London.
Weight loss has a direct relationship to the disappearance of diabetes. The pancreas is able to produce enough insulin to cover the body mass, and therefore, the patient returns to normality over time. It helps that the food intake also reduces.
However, bariatric surgery has been shown to dramatically take care of diabetes even before the patient has shed a few ounces of weight, Abeezar Sarela, senior lecturer in surgery, University of Leeds, U.K. “This has been well documented and reported.” Dr. Olbers explained, “Some patients lose the diabetes gradually just like the weight. But one of my patients went from using 500 units of insulin a day to nil just a day after the surgery.”
But he went on to add, “An additional magical thing is happening during surgery that increases the insulin sensitivity. While we do not know exactly how this works, we know that during surgery the gut communicates differently to the brain and intestine.” He indicated that the gastrointestinal channel could be the future area of research for those looking at therapy for diabetes.
However, bariatric surgery is not for all, Dr. Reddy cautions. The purpose of bariatric surgery is to ensure that a person is restored to health and wellness, and not cosmetic.
Obesity is an excess accumulation of fat, but morbid obesity is not just being lazy and eating heavy – it is a clinical condition. The determinants are Body Mass Index and a waist-hip ratio, and other existing conditions, right from migraines to varicose veins. With the Obesity Index of India (as per the National Family Health Survey) indicating that 19.8 per cent of men and 24.4 per cent of women were obese, it was necessary to pay attention to the problem. Surgeons offer their patients counselling on lifestyle modifications, including upping exercise and getting a hold on their diet, but Dr. Reddy added, “Beyond a point, this alone is not enough. For such cases, there is medical therapy, but that is not very effective. Surgery, with support from multiple departments, is the best intervention.”
The department of Surgical Gastroenterology, Apollo Hospitals, is organising a live bariatric surgery workshop and symposium on obesity in the city on Saturday and Sunday in Chennai.