Leading Bariatric Surgery Center in Punjab, India
When a person has weight which is about 20% more than the ideal body weight a person is said to be obese. Obesity is graded in terms of BMI (Body Mass Index) which is a statistical measurement derived from one’s height and weight. At BMI more than 23 person start showing sign of obesity. A BMI of more than 30 indicates that you are behavioral method have failed in controlling your weight and you are a candidate for bariatric/weight loss surgery.
BMI = Weight (in kg)/Height (in m2)
Factors leading to Obesity :
Some people are born with a predisposition to gaining weight and becoming obese. Factors that increase the person’s risk of becoming obese are genetics, lack of physical activity, family history, age, negative emotions, eating disorder.
Complications associated with Obesity :
Incident of heart attack with BMI more than 40 is about 10 times more in obese person. Obesity puts you at greater risk of developing diabetes, gall bladder diseases, hypertension, dyslipidemia, insulin resistance, breathlessness, sleep apnea, CHD, osteoarthritis, gout, reproductive hormone abnormalities and polycystic ovary syndrome and cancer.
Ways to overcome obesity :
Weight loss is usually possible through dietary changes, increased physical activity and behavior modification. One can reduce 10 to 15 kg excessive body weight with dieting and exercise but once you lose your weight another difficult task is to maintain the lost weight. In case when diet & exercise have failed then only best solution is bariatric/weight loss surgery, which not only helps to get rid of your extra weight but also controls your type-II diabetes, high cholesterol, snoring, sleep apnea, joint pains, etc.
Restricting to the amount of food which your body actually needs. That means it gives you feeling of fullness after you have eaten the small amount of food which is sufficient for your body and you don't like to eat more than that.
Optimise the absorption of calories in your food, actually according to the body needs.
After surgery you can start losing few kilos every month for a period of 12-18 months. You lose 60-80% of your excess body weight.
When your BMI is more than 27.5 kg/m2 and you have one of the medical conditions e.g. diabetes, arthritis, heart disease, high blood pressure etc.
If your BMI is 30 or more than 30kg/m2 without any medical problem (IDF guidelines for Asian’s).
If dieting and exercise failed in weight loss.
When you are unable to perform routine activities well in your day to day life.
1. Mini Gastric Bypass Surgery (MGB)
2. Laparoscopic Gastric Sleeve Resection
3. Laparoscopic Gastric Banding
4. Roux-en-Y Gastric Bypass
Before you decide to go for bariatric surgery you must know which procedure suits you as there are different type of surgical procedures which include :
1. Mini Gastric Bypass Surgery (MGB)
2. Laparoscopic Gastric Sleeve Resection
3. Laparoscopic Gastric Banding
4. Roux-en-Y Gastric Bypass
1. To bypass most of the stomach to reduce the amount of food one can eat.
2. To rearrange the small intestine so as reduce the calories the body can absorb.
Weight reduction pattern after surgery :
After the surgery individual start reducing weight slowly that is few kilos every month. Within 12-18 months patient achieve their target weight.
Recovery after surgery :
After bariatric surgery, people typically stay in the hospital for 2 or 3 days and return to normal activity within 2-3 weeks.
Bariatric Surgery is one surgery that resolves multiple serious health problems
There are number of serious health problems that reduce after surgery like :
Weight loss : Weight loss is first and biggest advantage of bariatric surgery. Individual who go through this surgery will lose 60-80% of his/her excessive body weight within 12-18 months.
Type II diabetes : Type II diabetes is resolved in 85-90% of patients. In fact in same gastric bypass cases, resolution of type II diabetes occurred within few days of the surgery.
High Blood Pressure : At least 70% of patients who have high blood pressure and who are taking medication to control it are able to stop all medication and have a normal blood pressure usually within two to three months after surgery.
High Cholesterol : Gastric By Pass surgery can help lower cholesterol and improve the ratio of total cholesterol to HDL cholesterol within six months of surgery nearly all patients with high cholesterol had normal blood cholesterol levels and 91% of patients who were on stains or other lipid lowering drugs before surgery no longer needed them.
Asthma / Respiratory Insufficiency : Most asthmatic find that they had fewer and less sever attach, or sometimes none at all. Improvement of exercise tolerance and breathing ability usually occurs within the first few months after surgery.
Sleep Apnea Syndrome : Dramatic relief of sleep apnea occurs as our patients lose weight, many report that within few weeks of surgery their symptoms were completely gone, and they had even stopped snoring altogether.
Gastro esophageal Reflux Disease : Relief of all symptoms of reflux usually occurs within a few days of surgery for nearly all patients, undergoing gastric bypass or bariatric surgery with crural repair.\
Low back pain, Degenerative disk disease and Degenerative joint disease : Patient usually experience considerable relief of pain and disability from degenerative arthritis and disk disease and from pain in the weight bearing joints. This relief tends to occur early, usually with the first 10-15 kg lost.
Infertility : Weight loss surgery may help infertility in obese women especially those that are infertile polycystic ovarian syndrome (PCOS). Significant weight loss after surgery can help restore normal menstrual cycle, reduce high androgen level and reduce the risk of type II diabetes all which plays a role in woman’s infertility. Bariatric surgery also decreases incidence of hirsutism in women.
Quality of life improved : After the surgery as patients found that they felt better, spend more time doing recreational and physical activities, benefited from enhanced productivity and economic opportunities and had more self confidence then they did prior to surgery.
Very Few people have complication after surgery. These are usually minor and manageable which include :
Nausea, Vomiting, Dumping, Infection, Ulcer, Temporary Hair Fall, Formation of gall stone, Nutritional deficiency. These are some small problems which are solved with counseling and multivitamin supplementation.
The cost of the Bariatric Surgery or Weight Loss Surgery in Punjab India varies according to the procedure most of the people think that bariatric surgery is very expensive because as they have to pay all together but they don’t think about long term benefits of the surgery. According to me this surgery is cost effective; one important reason is that weight loss surgery resolves conditions associated with obesity such as type II diabetes, high cholesterol etc., and so patients save money on related prescription, drugs, doctor visit and hospital visit. So, bariatric surgery is a step which increases your life expectancy. One starts living disease free life with normal weight and feels more active. It is a magic that changes your life…..
Myth : Bariatric Surgery is removal of fat from the body.
Fact : Not a single gram of fat is removed or liposuction is done in bariatric surgery. It is based on the principle of restriction of food & less absorption of food.
Myth : Weightloss surgery (Bariatric Surgery) is a new surgery.
Fact : It is a very old surgery. The first bariatric surgery was done in the year 1966. In India it is being done for more than a decade with figures as high as 15000 cases per year.
Myth : Bariatric Surgery is a cosmetic surgery.
Fact : This surgery not only reduces your over weight but also helps in the resolution of your comorbidities like Type II Diabetes Mellitus, High Cholesterol, Snoring, Sleep Apnea, Joint Pain, PCOD & Fatty Liver Disease. So, this is not a cosmetic but a life saving surgery.
Myth : All bariatric surgeries are same.
Fact : There are different type of bariatric surgery procedure for example Mini Gastric Bypass, Roux-N-Y Gastric Bypass, Gastric Band, Gastric Sleeve Resection, Duodenal Switch, SADI, Plication and ileal interposition.
Myth : All bariatric surgery lead to equal amount of weight loss.
Fact : Excess weight loss varies from procedure to procedure. Excess weight loss may range from 20% to more than 90%.
Myth : People who don’t eat much can not gain weight.
Fact : Sometime obesity is genetically related or over production of hunger hormones or slow metabolic rate of the body. An obesity prone person even eat less can gain weight for such people bariatric surgery is boon.
Myth : It is possible to lose your weight with diet & exercise.
Fact : Only 10-15% of the people can lose their weight with diet & exercise. If you stop the dietary and exercise regime all the lost weight can come back.
Myth : Bariatric surgery is reversible.
Fact : Some bariatric surgery are reversible like mini gastric bypass & gastric band.
Myth : You can eat very little after surgery.
Fact : Bariatric surgery allows to eat food according to your ideal body weight.
Myth : Bariatric surgery is done by open methods with large incision.
Fact : An experienced laparoscopic surgeon is able to perform bariatric surgery comfortably and successfully using laparoscopic technique.
Myth : You will vomit out if you eat more.
Fact : Procedure like gastric bypass reduces high pressure in stomach so negligible chance of vomiting. We at Jammu Hospital Jalandhar provide highest degree of professional excellence at an affordable price. A bariatric coordinator stays in touch with patient even once they are discharged.
What is mini gastric bypass surgery?
Mini Gastric Bypass Surgery started in 1997 is a simple, easily done, revisable and reversible weight loss surgery.
How it is done?
This procedure is done laparsocopically, making small five one cm holes on the abdomen. A long, narrow gastric pouch is made along the lesser curvature of stomach. A wide gastrojejunostomy is made at about 2m from the starting point of small intestine. It re-routes the food from gastric pouch to the distal part of small intestine, while bypassing the residual stomach and proximal part of small intestine, leading to less intake of food and less absorption of food. This causes low calorie absorption and hence gradual and sustained weight loss. The whole procedure takes about 20-30 minute.
How long is the hospital stay?
Patient stays in the hospital for 24-48 hours after the surgery. Patients start taking liquid diet shortly after the surgery, sometimes as early as few minutes, depending upon the level of consciousness and clearance from the recovery room doctors.
When does patient start walking after the surgery?
Usually within few hours of surgery patients are mobilized.
What is diet after Mini Gastric Bypass Surgery?
Patients start taking liquid diet on the day of surgery and switch to soft and solid diets within days of surgery. Patients are encouraged to have high protein, low carbohydrate and low fat diet after the surgery. Non-Vegetarian patients can have high proteins from egg, fish and chicken, whereas vegetarian patients can have high proteins from tofu cheese, soya milk, cereals and soyabean etc. Mediterranean diet like salads, Eating primarily plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts. Replacing butter with healthy fats, such as olive oil. Using herbs and spices instead of salt to flavor foods.
What diet should be avoided after MGB?
Diet high in carbohydrate, sugar and fats should be avoided for eg. Fizzy drinks, fried food, etc.
What supplements one has to take after MGB?
You need to take Vitamins (B12, Folic Acid, B6, Biotin etc.), Calcium in citrate form. Iron is required for menstruating females.
When can one start the normal routine work?
4-5 days after the surgery, light jobs can be started, which include office jobs. The jobs which require physical strength can be started 10 days after the surgery.
Do Not worry about Diet after Mini Gastric Bypass (MGB) Surgery.
DAY OF SURGERY :
• You can have light breakfast in the morning like cup of tea with biscuits.
• After 6 hours of fasting you are taken for surgery.
• After 6 hours of surgery you can again start taking clear liquids.
12 HOURS AFTER SURGERY :
You can start having clear liquids like :
• Water • Cononut Water • Lemon Water • Weak Tea
• Daal Water • Fat Free Milk • Clear Juices • Clear Soups
24 HOURS AFTER SURGERY :
You can start having :
• Thick Liquids and Soft Diet in the form of Soup (with Mashed Chicken and Mashed Vegetables)
• Lassi • Daal • Curd • Custard
• Soya Milk • Oats • Corn Flakes
• Thin Dalia and Khichri for one week until sutures are removed.
1 WEEK AFTER SURGERY :
You can start eating Normal Diet which is high in Protein and Fiber like :
• Whole Cereals • Pulses • Whole Fruits • Green Leafy Vegetables
• Soya Bean and its products • Chicken • Fish • Egg (only white part)
• Soaked Almonds • Walnuts • Milk and Milk Products
• Sprouts • Peanut Butter • Tofu • Cottage • Cheese etc.
EATING BEHAVIOURS FOR SUCCESS :
• Eat slowly and be aware of when you feel full.
• Chew, Chew, Chew!
• Avoid drinking fluids 30 minutes before and with your meals.
• Drink enough fluid between meals to meet your fluid requirements.
• Avoid food and beverages high in sugar.
• Avoid food high in fat and have no nutritional value.
• Learn proper eating habits that will promote weight loss while maintaining health at a reduced weight.
• Consume adequate amount of protein to minimize loss of lean body mass and facilitate healing.
• Take adequate amounts of fluid to maintain hydration.
• Obtain adequate nutrients for optimal health through vitamin and mineral supplementation.
• Smoking after surgery can be harmful.
Jammu Hospital is the only hospital in upper north with highest health quality accreditation NABH (National Accreditation Board for Hospitals & Healthcare Providers) & is also having centre of excellence status from IEF (International Excellence Federation for Bariatric & Metabolic Surgery).