23 September 2011
Ateenager weighing 180 kg recently went under the scalpel at a Mumbai hospital to lose weight. The doctor who performed bariatric surgery on Jalila Ramji (19), a Kenyan citizen, said she was one of the heaviest people to undergo the procedure in the city.
“When Jalila was brought to us, her body mass index (BMI) was 70, which meant she was super, super obese,” said Dr Abhay Agarwal, laparoscopic bariatric surgeon at Agarwal Hospital, Malad.
Suffering from an eating disorder called ‘comfort eating’, Jalila’s typical food intake would amount to 6,000 calories a day, thrice the average daily calorie need of a human adult-2,000.
Jalila started putting on weight as a child and weighed 120 kg when she was 12. For the last four years, she had been putting on about 15 kg every year. “She was constantly teased and was a subject of ridicule in school and college. Nobody wanted to be friends with her. She was so affected psychologically that she suffered from frequent bouts of depression,” said her aunt Rubina Jumma, who accompanied her for the surgery.
Her family consulted doctors in Kenya, to no avail. “She also tried exercising and dieting many a times in the past to lose weight. She would even do brisk–walking for four km every day and go on a liquid diet. But she couldn’t sustain the routine,” Jumma said. “She would soon get terrible pain in her knees and would just not be able to stay without food. Because of her weight, she had irregular or no periods.”
BENEFITS AND RISKS
- Weight–loss, or bariatric, surgery changes the digestive system, limiting the amount of food one can eat
- It helps one lose weight and can lower the risk of medical problems linked with obesity
- Gastric bypass is a common bariatric procedure because of its fewer complications
- Even after the procedure, to consistently lose weight, one must regularly exercise and have a healthy diet plan
- But gastric bypass is not for everyone. It is a major procedure and has risks and side effects, besides requiring permanent lifestyle changes
- Asians with a BMI over 30 and waist circumference more than 80 cm for women and more than 90 cm for men can consider opting for the surgery
The doctor makes 2 to 5 cuts in the abdomen to pass a laparoscope and other instruments. About 80–85% of the stomach is removed and the remaining joined together using staples. This creates a long vertical tube or banana–shaped stomach.
For children, the procedure is advised only after the epiphyseal fusion of bones occurs (when the growth centre located at the end of most long bones fuses with the end of the bone)
Hence, Sleeve gastrectomy is only recommended for girls over 16 years and boys over 18 years of age
Recommended only for those morbidly obese, or those with a body mass index of 40. In case of patients with chronic diseases such as uncontrolled diabetes or sleep apnea, the BMI limit is lowered to 35