Dr. Sumit Talwar, Chairman - Bariatric Surgery, Manipal Hospitals, Bengaluru, talks to ETHealthworld on how the growing percentage of obese population is adding to the burden of healthcare scenario. Edited excerpts:
How well has bariatric surgery been accepted in India?
Bariatric surgery is about treating obesity and we have to understand the obesity epidemic that has swept the whole world. In the developed countries almost 2/3rd of the population is obese and almost 1/3rd is morbidly obese. Morbidly obese patient are those who need bariatric surgery to lose weight urgently so as to prevent all the complications.
India is not far behind, it is an estimate that about 10 to 15 percent of Indian population is obese and about half of them would be such that will need bariatric surgery to reduce weight. In India bariatric surgery has developed over the past 10 to 12 years and currently they are doing about 15,000 odd cases in a year. World over the bariatric surgery is evolving for the past 20-25 years now.
Initially we were doing open bariatric surgeries which means cutting open the abdomen. Nowadays it has shifted to laparoscopic method which has become much safer and much comfortable for the patients and the recovery is faster today
What are the challenges that you face in convincing a patient for reducing weight?
The biggest challenge that we face today is that people still think that being obese is the fault of the person being obese. This mindset has to change among the patients, the doctor and physicians who are caring for these patients. It is not always entirely the patients fault for being overweight.The other challenge I face is in convincing patients that they need to lose weight but most patients won't be able to loose alot of weight just by dieting and exercise.
Almost everyone try diet and exercise for a significant period of time before we offer bariatric surgery to them. The third problem is that most people want to delay surgery for as long as possible as it is thought as an irreversible and a big thing. So the general public and the physicians who are taking care of obese patients need to be educated that surgery is not the last resort but should come much earlier so that we can prevent all the complications and the problems that are associated with being overweight. This way we can give them a better quality of life, increase their life span and avoid all the diseases that are associated with obesity life diabetes, hypertension, high blood cholesterol obstructive sleep apnea, arthritis spine problems and many more.
Tell us about Manipal's weight management programme. How is this approach a differentiator among other hospitals?
Here at Manipal we have a holistic approach to the problem, we know and we believe that not every patient who is overweight is a candidate for surgery and not every person who would ultimately be a candidate for surgery should be offered surgery. We have a comprehensive Manipal weight management programme which involves non-surgical as well as surgical management of obesity.
We have a full-fledged team of experts including dieticians, exercise physicians and therapists who will assess the nutritional status and modify the diet advice on exercise. Then we filter out patients who have not benefitted from the medical weight management program, they are then offered surgery on the basis of their BMI and other problems.
How much would a patient have to pay for undergoing a bariatric surgery?
The cost varies according to the type of operations done. It starts at about 3 lakhs and then goes up according to the surgery and the number of days the patient has to stay in the hospital.
How do you see the future evolving?
In the near future I think the direction would be two-fold; one is that the types of surgeries will evolve- we will get newer and different types of operations for evaluating and performing weight loss. The other significant thrust would be in non-surgical arena. There are lot of exciting things coming up like endoscopic sleeves, pacemakers and I believe that one day we might find a hormone or a pill that controls the hunger and allow the person to lose weight without having the side effects that we have of the current medications.