Weight-loss surgery can prove fatal

Losing weight is turning out to be a dangerous fad with more and more people going under the scalpel, either unaware of the risks involved or willingly taking the gamble.
But the consequences, which many surgeons and patients tend to ignore, could be fatal. A grim reminder of this came last Wednesday when a 25-year-old businessman died in Ahmedabad after undergoing bariatric surgery — a process where part of the stomach is stapled or bypassed to reduce the appetite of a patient to help him or her shed those extra kilos.

The examples are worryingly in plenty.

A businessman from Khar (Mumbai) died a few months after a similar surgery in 2007.
Early this year, BJP leader Jagat Bhushan Johar died while undergoing a weight-loss operation.

In 2006, a Mumbai girl, who weighed 180kg, died a week after undergoing stomach-stapling surgery — she reportedly had a heart attack.

Similar cases have been reported from other parts of the country, but it hasn’t deterred those wanting to lose weight quickly. The number of people undergoing bariatric surgery has almost doubled in the last two years, according to weight management experts.

“There are clear guidelines delineating at what weight and on whom bariatric surgery should be performed. Adherence of these guidelines minimises the risks,” said Dr Anoop Misra, a former AIIMS specialist and now director, department of diabetes and metabolic diseases, at Fortis Hospital, Delhi.

Though the risk of developing complications after bariatric surgery is 1:400, Misra said because of the lack of effective regulation, some doctors are performing the procedure on patients who do not require it.

“Advertising bariatric surgery as a cure for heart disease and diabetes, or performing it on patients below a certain age or those who do not fit the bill, is unethical and should be strictly curbed,” he said.

Dr Vijay Arora of Delhi’s Sir Ganga Ram Hospital said bariatric is a high-risk, super-specialty surgery. “The evaluation has to be complete, taking into account the will power, and changes in the diet and lifestyle of the patient. And surgery should be the last resort,” he said.

Arora said there is a strong possibility that the patient in Ahmedabad died due to anaesthesia complications.

But Dr PK Ganguly of Delhi government’s Ram Manohar Lohia hospital said surgery is the only option for patients suffering from co-morbid conditions like hypertension, cardio-vascular diseases and diabetes. Doctors, however, have to be careful as one cannot predict how a patient will react to surgery, he said.

Agrees Dr Sandeep Malhotra, an expert in minimal access abdominal and weight-loss surgery with Gurgaon’s Artemis Hospital. “For many people, there is simply no other choice,” said Malhotra, who has conducted 80 weight-management surgeries this year, compared to 30 in 2008.

Dr Sanjay Borude, Breach Candy Hospital, said patients and their relatives should be made fully aware of the risks involved. “However, the risks mostly arise when the patient does not follow the post-operative guidelines,” he said.

Dr Shashank Shah, a bariatric surgeon from Pune who performed 250 such operations last year, said it is an emerging fad and even youngsters look at it as a short-cut to reduce weight.

Though its costs more than Rs3 lakh, most people don’t mind paying up, hoping that they will look slim and fit after the surgery, he said. “We, however, treat surgery as an option only if medical treatment fails,” Shah said.

(With inputs from Jyoti Shelar in Mumbai and Anuradha Mane Wadhwani in Pune)