Scrap The Fat!

While on one end of the spectrum, malnourishment is a serious issue in India, there also exists an equally serious problem of obesity that often goes unnoticed in the midst of everything else that plagues its cities. Dr. Muffazal Lakdawala, Founder of CODS and Chairman of Minimal Invasive Surgery at Saifee Hospital, Mumbai, gives us a little insight into everything you need to know about obesity and digestive surgery

India, as a country, has always been a little less dependent on the concept of junk food except for the recent times and that too in metro cities more than anywhere else. Yet, a significant portion of the youth faces the problem of obesity. Why do you think that is?
Parents have one of the most major influences on dietary habits of their children. Indian families commonly carry the misconception that heavier children are healthier children. Most often this belief is compounded by the thought process that as the children grow up they will eventually grow out of their baby fat. I believe that the first barrier to developing healthy food habits in children, needs to be overcome at home. Parents must be educated about healthy feeding practices and the right food choices. Once the right foundation is set, children find it easier to continue with those habits. The next big influence is the schools and teachers. I believe that schools must banish junk food and encourage only healthy local food. Junk food outlets in schools must be discouraged.

What do you consider a practical or feasible age for anyone to opt for surgery when it comes to obesity and why?
As per the guidelines obesity surgery may be recommended for a morbidly obese adolescent who is more than 16 years of age and has attained full growth as per the Tanner’s criteria. The patient must undergo at least six months of supervised conservative treatment in terms of diet and lifestyle modification.

While you specialise in digestive surgery and obesity treatment solutions, what would you say is the most effectively natural way for treating obesity, given that not a large portion of the youth considers surgery as an option for this problem?
I personally do not recommend surgery for very young patients and adolescents unless pushed to the brink. The best way according to me would be “prevention” of obesity. First five years of a child’s life are the most important when parents and teachers play a big role in inculcating the right food habits. We need to set the right example for our children so that they do not fall into this web of overweight and obesity. Physical activity is equally important and I urge the schools to focus on that as well. Most schools concentrate only on academics and eventually turn the kids into couch potatoes.

What are the most common myths about obesity and why are they so hard to dispel?
One of the biggest myths about obesity is that it is genetic. Yes genetics do predispose you to becoming obese but it is mainly your lifestyle that pulls the trigger. You may inherit the genes but it may not be your destiny. The next big myth is the relationship between hypothyroidism and morbid obesity. Most patients who come to us are hypothyroid but they need to understand that hypothyroidism leads to a weight gain of up to eight to 10 kg, not more. Massive weight gain cannot be attributed to the thyroid alone.
Female patients tend to think that weight gain happens after gynaecological surgeries like hysterectomy. Some patients also believe that certain nutritional supplements like calcium can lead to weight gain. Well, morbid obesity is multi-factorial but lifestyle plays a major role. Diet and lifestyle modification are the first step towards treatment of morbid obesity.

Have there been cases where people have been treated for obesity and have had the problem recurring even after surgery?
Revision surgery is a part of the spectrum of bariatric surgery. Revision is usually required in cases of super-obese patients who may need a second stage surgery to achieve optimum weight loss. Bariatric surgery is one field where life-long follow up is warranted. Bariatric centres that do not focus on follow up tend to have poorer results as compared to centres that focus a lot on follow up. At our centre follow up team is led by a team of experienced dieticians who handhold the patients from the pre-operative phase. Lifelong follow up is a must to get best results.

What would you consider as the top tips in your to-do list for a healthy lifestyle?
-Eat healthy and on time
-Be active and exercise
-Sleep for at least seven to eight hours in a day.
-Set the right example for the next generation!

Volume 5 Issue 3