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Last Thursday, eleven–year–old Sanchita Bose became one of the youngest to undergo bariatric surgery in the city. Young teens going under the knife to cut their weight may not sound shocking anymore but what made Sanchita’s case unique was that her obesity was purely related to a lifestyle high on junk food and zero physical activity.

So far, bariatric surgery has rarely been performed on obese people so young unless they have had life–threatening medical implications arising out of genetic or hormonal anomalies. But Sanchita was born a perfectly healthy child in a well–to–do household. Before the surgery, she weighed a staggering 98 kilograms, almost triple the weight of children her age.

Born to her parents after 12 years of their marriage, Sanchita’s father Sudhir, a general manager in a leading private firm, admitted that "she was pampered and fed a rich diet". It was only after she turned six did they realize that she was too "heavy" for her age. But, by then, the child, a topper in her class, was used to travelling by car and not participating in any extra–curricular activities. "Her obesity alienated her from friends and school. She struggled to even walk 50 metres. Exercising or running was not an option as her knees would hurt," said the father who added that she was often ridiculed for her weight.

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Soon, health complications begun, and she became a diabetic dependent on daily doses of insulin. She was also borderline hypertensive. Desperate to reclaim their daughter’s life, the family resorted to sleeve gastrectomy, a procedure where a portion of her stomach was removed permanently. After the surgery at Criticare Hospital in Andheri, Sanchita has knocked off a few kilos already, claimed her treating doctor and bariatric surgeon Dr RK Sinha.

The use of bariatric surgery to treat obesity in children and adolescents is still being debated the world over. But notwithstanding the debates and long–term concerns, parents have been flocking to clinics offering such surgeries. 30% adolescents in metros are obese, show studies Mumbai: Eleven–year–old Sanchita Bose, who became one of the youngest to undergo bariatric surgery in Mumbai, had developed sleep disorder and arthritis, among other health issues. Justifying Sanchita’s surgery, her doctor and bariatric surgeon Dr R K Sinha said "Her body mass index (BMI) stood at a whopping 44 (20–25 is normal for her age)."

Senior bariatric surgeon Dr Ramen Goel, who consults at the Nova Teen facility at Chembur’s Nova Specialty Surgery Centre, said that they have operated on 22 adolescents since the inception of the centre in June last year. "I had done an equal number of cases in the last 12 years put together," he said. About 10,000 bariatric surgeries are estimated to be performed in the country every year, of which only 2–4% are believed to be children or adolescents. Studies suggest that at least 30% adolescents in metros are obese.

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International guidelines are clear that obesity surgeries are not for all, and suggest that the ideal age for girls is 12 and for boys 15. "But, exceptions can be made if the case demands, and provided the patient has attained the required skeletal growth," said Goel. India still does not have guidelines overseeing these surgeries.

The key to using bariatric surgery in children or adolescents, as surgeon Dr Sanjay Borude puts it, is the right selection of patients. He claimed to have recently sent a nineyear–old child home after training the parents on how to control his eating habits. "Both the parents were working and the child felt neglected. I suggested that one of them quit their jobs and the mother did so to normalize things," he said.

Borude also cited the example of a12–year–old girl from a leading political family, who was on the verge of committing suicide as she was staying in a hostel and grappling with weight issues.


Source
Times of India
22 July 2013, Mumbai, India.

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