MUMBAI: In February 2021, Rupali Kadam, a policewoman from Mumbai, will observe a happy anniversary of the day she underwent bariatric or weight-loss surgery. “My life is fantastic compared to what it was two years back,” she said in between one of her hectic 10- to 12-hour shifts that most police personnel have had to do during the Covid-19 pandemic.
Rupali, who weighs 79 kg today, was often called names when she stood for traffic duty with her 132-kg frame. She then opted for non-traffic duty but she recalls she would often hear taunts about her weight, especially in elevators. “Now, people walk up to me to compliment me about how good and healthy I look,” said the 32-year-old policewoman, adding that she hopes to lose even more weight.
Obesity, recognised as a worldwide epidemic, has emerged as one of the worst risk factors for Covid-19 in recent months. A person is said to be overweight to obese if his/her body mass index (ratio of weight versus height) is 25 or greater. The World Health Organisation says that over 1.9 billion adults were overweight in 2016. In India, a study by the Indian Council of Medical Research (ICMR) in 2015 found that the prevalence rate of obesity varied from 11.8% to 31.3%. In urban areas, it said more than 30% of the population was obese or overweight, women more than men.
Like with any disease, obesity treatment has been a subject of intense research. Surgery has emerged as the way forward for many morbidly obese people, resulting not only in weight loss but also in getting rid of a host of chronic diseases ranging from hypertension, dislipedmia and, many cases, even diabetes. “But the type of bariatric surgery and patient selection has to be done with care,” said endocrinologist Dr Shashank Joshi. Obesity pills have been around for decades, but most fail due to side-effects; the only one currently approved for use (Orlistat) is a prescription-only pill in India. “Meal replacement substitutes, eating less, exercise and behaviour change help obese patients,” said Dr Joshi.
A patient, who did not want to be named, said weight gain after reaching 120 kg is quick. “You can manage to do things on your own when you are 100 or 120, but thereafter you need help to even get up from a sofa,” the patient said.
Fifty-year-old Sheela Natrajan, a law lecturer from Mumbai’s western suburbs, decided to undergo bariatric surgery (in two phases, two years apart) when her weight suddenly shot up to 195 kg. “People are wary of surgery because they fear something could go wrong sometime in the future, but I tell them that it is important to minimise your pain right now,” said Natrajan.
The world’s first bariatric surgery was done in 1954, but it is only now that long-term studies on its effects, especially on quality of life, are trickling in. A study published in 2016 in the European Journal of Clinical Nutrition found a significant increase in quality of life both in the short- and long-term after bariatric surgery.
Surgeon Dr Muffazal Lakdawala, who operated on both Rupali and Sheela, said that bariatric surgery gives patients an opportunity to gain back all the simple joys of life they had to miss out on due to obesity. “There are women who suffered infertility for years, but could get pregnant and have babies after bariatric surgery. I once operated on a mechanic who couldn’t get under the cars because he was obese. Surgery gives people a second chance,” he said.
Natrajan, who now weighs between 77 kg and 80 kg, has turned her life around in the decade since she underwent her first weight-loss surgery. “Previously, I would be happy to just complete my lectures, but I now multi-task,” she said. Apart from lectures, she also takes long walks and Zumba classes. “I have had no maids to help out during the Covid lockdown and manage all the housework on my own,” she said. Two years back, she went to the United Kingdom to do her second master’s degree in law and plans to do a doctorate soon.