Interviewed Dr Sarfaraz Jalil Baig

Obesity is the greatest pandemic of the post modern age. It has shattered the lives and families of countless people in the west and has now become a serious health crisis for children and adults in the developing world. During the 33 years studied, rates of being obese or overweight soared 28 percent in adults and 47 percent in children. During that span, the number of overweight and obese people rose from 857 million in 1980 to 2.1 billion in 2013. That number exceeds the total world population of 1927, when it first hit 2 billion. Ranging from cardiac problems and stroke in adults to Type-2 Diabetes in teenagers the psychological and emotional impacts of obesity in all age groups tend to rise one pound at a time.
Obesity, especially among young people leads to social withdrawal, low self-esteem, behavioral problems and impotence (more among girls and young women) and when such problems are further compounded by increased risks of heart disease, cancers (colon, breast and uterine ) and sleep apnea; an obese person may be equated to a walking time bomb. The Stethoscope team had a chat with Dr Sarfaraz Jalil Baig an obesity expert based in Bellevue Clinic, Kolkata, India who spoke on the importance of surgical correction of obesity.

Stethoscope: Please tell us about the surgical techniques for obesity treatment and the scope of such surgery in Bangladesh.
Dr Baig: Bariatric surgery is an operation on the stomach and/or intestines that helps patients with extreme obesity to lose weight. This surgery is an option for people who cannot lose weight by other means or who suffer from serious health problems related to obesity. It was started in the 1950’s in the USA but was less popular because the procedure was considered dangerous as it involved large incisions, prolonged hospital stay and other complications.
With the advent of laparoscopic techniques, where surgeons began to perform procedures by inserting surgical instruments through small holes in the abdomen, bariatric surgery started to gain popularity straight away. Due to the evolution of better techniques, shorter hospital stay and excellent results within short duration of surgery, the procedure became popular all around the world and in India we have been performing bariatric surgery since 2002.
In developing nations like Bangladesh and India where obesity is still not a public health concern, governments or NGOs in our countries are yet to formulate or implement nationwide strategies to prevent it. But the number of overweight and obese children, teenagers and adults are increasing rampantly and these people and their families must do what they can to help their loved ones. Bariatric surgery is the key to those adults who are suffering from morbid obesity.
In Bangladesh, some private clinics are offering bariatric surgery for obese diabetic patients. For the comprehensive treatment of morbid obesity there should be a team comprising of surgeons, nutritionists and endocrinologists but there is still very little impetus in that direction.
Stethoscope: Please tell us of the pros and cons of bariatric surgery.
Dr Baig: Bariatric surgery has two types. Restrictive surgeries work by shrinking the size of the stomach and slowing down digestion. After surgery, the stomach may at first hold as little as an ounce, although later that could stretch to 2 or 3 ounces. Lesser the patient eats, more weight is lost. Malabsorptive/restrictive surgeries change how a patient takes in food.
The procedure gives patients a smaller stomach and also removes or bypasses part of the digestive tract, which makes it harder for the body to absorb calories. Either ways weight loss is enormous. For example, if a person’s ideal body weight should be 70 kilo but he weighs 150 kilos, bariatric surgery can bring about weight loss of 70-80 % of that excess weight gain.
The psychological impact of weight loss can also be enormous. One of the downsides of such a procedure is that it can cost anywhere from 2 lakhs to 5 lakhs taka, as the technique and apparatus demanded may according to the patient’s choice of procedure. The common complications of both varieties of weight loss surgery are common for any other gastrointestinal procedure and they include anesthetic hazards, bowel or gastric perforation but a more common problem which is seen more among patients who undergo the malabsorptive weight loss surgery is, as the name suggests - malabsorption of micronutrients.
That’s why it’s important for surgeons to work in close association with nutritionists and endocrinologists for the post operative management and follow up of patients who undergo weight loss surgery.?
Dr Sarfaraz Jalil Baig
MS FRCS, FIAGES
Gastrointestinal, Laparoscopic and Bariatric Surgeon
Belle Vue Clinic, Kolkata, India
(He is the first surgeon in the world to do laparoscopic adrenalectomy successfully in a 3 month old baby)

 

Interviewed Dr Sarfaraz Jalil Baig

Obesity is the greatest pandemic of the post modern age. It has shattered the lives and families of countless people in the west and has now become a serious health crisis for children and adults in the developing world. During the 33 years studied, rates of being obese or overweight soared 28 percent in adults and 47 percent in children. During that span, the number of overweight and obese people rose from 857 million in 1980 to 2.1 billion in 2013. That number exceeds the total world population of 1927, when it first hit 2 billion. Ranging from cardiac problems and stroke in adults to Type-2 Diabetes in teenagers the psychological and emotional impacts of obesity in all age groups tend to rise one pound at a time. Obesity, especially among young people leads to social withdrawal, low self-esteem, behavioral problems and impotence (more among girls and young women) and when such problems are further compounded by increased risks of heart disease, cancers (colon, breast and uterine ) and sleep apnea; an obese person may be equated to a walking time bomb. The Stethoscope team had a chat with Dr Sarfaraz Jalil Baig an obesity expert based in Bellevue Clinic, Kolkata, India who spoke on the importance of surgical correction of obesity. Stethoscope: Please tell us about the surgical techniques for obesity treatment and the scope of such surgery in Bangladesh. Dr Baig: Bariatric surgery is an operation on the stomach and/or intestines that helps patients with extreme obesity to lose weight. This surgery is an option for people who cannot lose weight by other means or who suffer from serious health problems related to obesity. It was started in the 1950s in the USA but was less popular because the procedure was considered dangerous as it involved large incisions, prolonged hospital stay and other complications. With the advent of laparoscopic techniques, where surgeons began to perform procedures by inserting surgical instruments through small holes in the abdomen, bariatric surgery started to gain popularity straight away. Due to the evolution of better techniques, shorter hospital stay and excellent results within short duration of surgery, the procedure became popular all around the world and in India we have been performing bariatric surgery since 2002. In developing nations like Bangladesh and India where obesity is still not a public health concern, governments or NGOs in our countries are yet to formulate or implement nationwide strategies to prevent it. But the number of overweight and obese children, teenagers and adults are increasing rampantly and these people and their families must do what they can to help their loved ones. Bariatric surgery is the key to those adults who are suffering from morbid obesity. In Bangladesh, some private clinics are offering bariatric surgery for obese diabetic patients. For the comprehensive treatment of morbid obesity there should be a team comprising of surgeons, nutritionists and endocrinologists but there is still very little impetus in that direction. Stethoscope: Please tell us of the pros and cons of bariatric surgery. Dr Baig: Bariatric surgery has two types. Restrictive surgeries work by shrinking the size of the stomach and slowing down digestion. After surgery, the stomach may at first hold as little as an ounce, although later that could stretch to 2 or 3 ounces. Lesser the patient eats, more weight is lost. Malabsorptive/restrictive surgeries change how a patient takes in food. The procedure gives patients a smaller stomach and also removes or bypasses part of the digestive tract, which makes it harder for the body to absorb calories. Either ways weight loss is enormous. For example, if a persons ideal body weight should be 70 kilo but he weighs 150 kilos, bariatric surgery can bring about weight loss of 70-80 % of that excess weight gain. The psychological impact of weight loss can also be enormous. One of the downsides of such a procedure is that it can cost anywhere from 2 lakhs to 5 lakhs taka, as the technique and apparatus demanded may according to the patients choice of procedure. The common complications of both varieties of weight loss surgery are common for any other gastrointestinal procedure and they include anesthetic hazards, bowel or gastric perforation but a more common problem which is seen more among patients who undergo the malabsorptive weight loss surgery is, as the name suggests - malabsorption of micronutrients. Thats why its important for surgeons to work in close association with nutritionists and endocrinologists for the post operative management and follow up of patients who undergo weight loss surgery.? Dr Sarfaraz Jalil Baig MS FRCS, FIAGES Gastrointestinal, Laparoscopic and Bariatric Surgeon Belle Vue Clinic, Kolkata, India (He is the first surgeon in the world to do laparoscopic adrenalectomy successfully in a 3 month old baby)