Myths Surrounding Bariatric and Metabolic Surgery

By Dr. Ameya Sanjiv Thakur
Pune: Surgical interventions designed to address obesity collectively fall under the umbrella of metabolic or “bariatric” surgery, derived from the Greek words “baros” (meaning “weight”) and “iatrikos” (meaning “medicine”).

OBESITY IS NOT ALWAYS ABOUT EXCESSIVE EATING. IT’S ABOUT THE COMPLEX INTERACTION BETWEEN OTHER CO-MORBID CONDITIONS LIKE DIABETES, HYPERTENSION, METABOLIC SYNDROME, ETC.

MYTH 1 – BARIATRIC SURGERY IS RISKY – PEOPLE FACE MORE RISKS FROM COMPLICATIONS OF OBESITY THAN THE RISKS OF OBESITY SURGERY. THE MORTALITY RATE IS LESS THAN 1%. Risks are comparable to other routine cases like gallstones, hernias, appendicitis, hip replacements, etc.

MYTH 2 – Bariatric surgery is a cosmetic procedure – While it certainly improves appearance, its primary impact lies in enhancing the quality of life and alleviating conditions like diabetes, hypertension, osteoarthritis, dyslipidemia, obstructive sleep apnea, etc. In fact, 70 to 90% of my patients are off medications for type 2 diabetes and thyroid disorders.

MYTH 3 – Bariatric surgery is a quick fix – NO, it’s not. It commences with a 1-month pre-operative diet consisting of liquids and a low-carbohydrate diet. Following approval from our anesthesia team, the patient undergoes surgery. Post-surgery, the patient adheres to a liquid diet (high protein, low carb) for around a month before resuming a normal diet. This entire process takes approximately 3 to 4 months.

MYTH 4 – WEIGHT REGAIN AFTER SURGERY – 80 to 90% of my patients have maintained their weight loss. If patients don’t exercise or maintain healthy eating habits, weight regain is likely. IN CASE OF WEIGHT REGAIN, WE OFFER REVISIONAL BARIATIC SURGERY, DEPENDING ON THE INITIAL PROCEDURE. Patient compliance with exercise, a healthy diet, and avoiding soft drinks, pizza, burgers, etc., determines the likelihood of weight regain.

MYTH 5 – INSURANCE COMPANIES DON’T COVER BARIATRIC SURGERY – Nowadays, most insurance companies cover bariatric surgery. Proper indications, such as a BMI ≥ 40 kg/m² without coexisting medical problems, or a BMI ≥ 30 kg/m² with severe obesity-related comorbidity, are required. Comorbidities include type 2 diabetes mellitus, hyperlipidemia, hypertension, obstructive sleep apnea, etc.

(About the author: Dr. Ameya Sanjiv Thakur is an Advanced Laparoscopic GI, Bariatric & Metabolic Surgeon, holding qualifications MS, FIAGES, FAIS: FALS (Hernia), FALS (Bariatric), FALS (Robotic), MBBS.)