Metabolic Surgery: New Ray of Hope for Diabetic Patients

By Samachar Digital News 

Ludhiana, February 14^th, 2020:- India faces major health challenge from “obesity in young” and unless this rapidly spreading epidemic is not checked in time, it will continue to predispose to a host of related disorders like Type 2 Diabetes Mellitus, hypertension, heart disease, sleep apnea, infertility and lipid disorders. A recent study also linked morbid obesity to 13 types of cancer.

In Punjab more than 37% percent of population is either overweight or obese and their body-mass index (BMI) is high. Although, these disorders existed in State earlier too, in the last one decade, the proportion of population with these conditions has increased drastically, says  Dr. K. S. Kular (M.S.) (Laparoscopic Surgery Specialist & Director, Kular Hospitals Pvt Ltd, who sees scores of patients with obesity related issues every day, he warns that obesity was spiking Punjab's burden of “lifestyle diseases”. People with high fasting glucose and high total cholesterol have more than doubled too. India is the 3rd most obese nation with more than 13.5 cr people suffering from Obesity, surpassed only by China and the US.  

Dr. K. S. Kular (M.S.) (Laparoscopic Surgery Specialist & Director, Kular Hospitals Pvt Ltd,  while interacting with media persons, here in Ludhiana explained that why obesity should not be taken lightly. He said that, “Obesity is a complex disease that can impact the physical, mental and socio-economic well-being of the individual. In my clinical experience, obesity in women is associated with depression. This can fuel a vicious cycle – if you don’t feel good, you eat comfort food. Unfortunately, the impact is not only devastating for the individual but also for their personal life – increasingly, obese patients are reporting marital problems that even lead to divorce.

Asked if anything could be done to address this health risk, Dr Kular responded that: “Acceptance is the key”, it was necessary to accept that the overweight we have is not “healthy” as many people refuse to accept that they are overweight or obese. “Second,” he said that we have to accept that we are eating more than what we are spending.” Creating a balance between calorie intake and expenditure, coupled with lifestyle changes could help reverse the grossly flipping weighing scales. Dr. K. S. Kular added that Obesity is a complex disease that can impact the physical, mental and socio-economic well-being of the individual. Obesity in women is associated with depression. This can fuel a vicious cycle – if you don’t feel good, you eat comfort food. Unfortunately, the impact is not only devastating for the individual but also for their personal life – increasingly, obese patients are reporting marital problems that even lead to divorce.

Dr. K. S. Kular stressed that, while a significant population of men & women in the state are either overweight or obese, a recent study has shown that young children are also falling prey to this health disorder.  Lack of outdoor activities is fueling childhood obesity. These days, children are given mobile phones and laptops which they may find more entertaining than playing outside. Not only does this lead to the risk of obesity, but also to Vitamin D deficiency – which is a risk factor for both obesity and diabetes.

Despite the consequences of leaving obesity untreated, obese patients do not always consult a medical professional. Dr. K.S. Kular observed that in the Indian scenario, more than 60% of individuals wait more than 6-10 years to seek out medically sound weight-loss procedures. Usually such patients are diagnosed with two or more co morbidities, such as diabetes. In my practice, he has observed a rapid rise in the incidence of infertility, depression, NAFLD, kidney failure, cancers, sleep apnea and heart attacks in patients.

Obesity treatment plans aim to limit weight gain, and eventually help patients reach and stay at a healthy weight. Treatment plans usually include diet and lifestyle recommendations, medications and bariatric surgery for eligible patients. Dr. K.S. Kular explained that when obesity is treated effectively, many co morbid diseases also show improvement. For instance, bariatric surgery is proven to help control Type 2 Diabetes in obese patients and other co morbidities, which helps reduce mortality.

Dr. K.S. Kular pointed out that patients can proactively consult a physician to understand whether they are eligible for bariatric surgery – before problems develop, Most patients seek bariatric consultation when they develop Type 2 diabetes, sleep apnea or when they are refused a knee replacement surgery by an orthopaedician. But with increasing awareness about the role bariatric surgery can play in controlling obesity and diabetes, patients can proactively seek medical advice before their conditions worsen. Once there is a steady and uncontrolled weight gain, it is best to consult a medical expert who can help identify the cause and advise corrective measures.

Dr. K.S. Kular added that Worldwide, of the four million deaths attributed to excess body weight in 2015, nearly 40% occurred among those whose body mass index (BMI) was above the threshold of obesity, i.e., 30 or above. Stigma associated with Obesity leads to patients not seeking the right treatment and blaming themselves for the condition, obesity is a Disease which needs treatment by obesity specialist, and government is also taking it seriously and taking strong steps to halt the increasing incidence. The National Multi sectoral Action Plan for prevention and control of common NCDs. NMF. National Monitoring Framework Ayushman Bharat and Fit India Moment are namely the main ones.

To help ensure that severe obesity is treated with proven methods, insurance coverage of obesity treatment is a key policy step. Dr. K.S. Kular that in his experience, many patients avoid seeking obesity treatment due to financial concerns. Some even question whether they should spend money on a ‘cosmetic’ need. Obesity is a serious medical condition. Covering its treatment with insurance would cement awareness and encourage many patients to seek appropriate medical treatment.” He also informed that Insurance also now treats obesity treatment as per medical advice for morbidly obese. Insurance will cover medically advised treatment as per new IRDAI regulation and all policies will have to comply from October 2020 onwards.