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Different types of weight loss surgeries in India (and why it never works)

Posted on July 28 2020

Different types of weight loss surgeries in India (and why it never works) | Roshni Sanghvi

Time to Read: 10 Minutes

Time and again I have frustrated clients coming upto me at the gym asking if they should resort to liposuction or bariatcic surgery as a form of last resort. 'I have tried everything' they would say, and honestly speaking, they are not entirely wrong. If you are reading this article, you have either considered this option for yourself or for a concerned loved one and want to know more about the procedure. 

Weight loss is a over a billion dollar industry and everyone from doctors to entreprenures want a cut of this share. There is a new diet in the market every hour and some straight face liar behind the same trying to show you how their diet (or diet product) is the only way for you to get fit. There is a market for everything from tea- tox'es to appetite suppressant lollipop's. Quite honestly its confusing and scary.

Sit in a room full of people and the one topic that is sure to stir an argument is your food choices. High- carb is wrong, high- fat. is wrong, high- proteins is wrong. Basically, if you eat food, its wrong. And then there are promoters of 'eat natural' and 'eat like our grandmom's ate' but then you see the same people dip their phulka's in extra ghee and sit hours in front of the screen UNLIKE the grandmom's. 

This whole circus can lead people switching from one diet to another every week and declare 'I'v tried everything, nothing works'. Ok, lets take a step back and understand why someone is not losing weight. There really are only three reasons:

  • You are eating more than required.
  • You are moving less than required.
  • You have an underlying hormonal imbalance and your diet is making the same worse.

Thats it! No plateau, no low metabolism, no BS. I have met people who eat only twice a day, limit their calories, go for a walk and have no hormonal problems but are still not losing weight. So what's wrong? So many things could still be wrong:

  • Too many calories over the weekend (junk weekends).
  • Alcohol and substance abuse.
  • Not training at the right intensity to see fat loss.
  • Bad sleep/ recovery cycle.
  • Lack of micro nutrient food leading to binge eating episodes.

This is why you need a nutritionist and guidance to help you get in shape. Anyways, let's forget the people whoa re below 150 kilo's and can reduce with with just lifestyle changes and exercise. What about people who are over 150 kgs and honestly cannot move anymore. Should liposuction be the only solution for them? Not according to the below research:

There really is not max number on the scale after which you cannot reduce weight. If not diet and exercise, lifestyle changes alone is enough to help you get started. The problem is keeping yourself constantly motivated. So hire a motivation coach. The cost of a fitness coach, a nutritionist and a motivation coach for a period of 1 year combined is still less than the cost you will pay for the surgery. 

But why put in all the work! Just get the damm surgery and get it done with, right? Well lets discuss the options you have below:

There are two popular types of liposuction surgeries currently available:

1) Stomach Stapling: This procedure is also known as Vertical band Gastroplasty (VBG) and literally means stapling the stomach. See the below image to understand more:
There is a hole drilled in the middle of your stomach and one side on the top is completely stapled. The other side has a silastic ring that slows the food from going down. An average human stomach holds upto 4- 5 cups of food but with this procedure, you can only hold one cup worth of food in the area marked as the 'pouch'. So what happens if you eat more than that, well you vomit.
For the rest of your existence, you cannot eat more than a few tbsp worth of food. Imagine never ever sitting for a meal and being able to eat an appetizer, entree, main and dessert in one meal. While sitting for a celebration with the family, you are only allowed to eat 2-3 tbsp worth of food and have to stop. Most people who opt for bariatric surgeries are doing so because they do not have portion control, ironically, this surgery just forces you to control your food potion to sustain the weight loss.
Now since you are anyways willing to do this 'for the rest of your life', why not instead follow a much less restrictive meal plan for a few months to get in shape? Simply switch to food that is low in calories and high in volume?

Side effects aside, do you know you can actually die, dying to lose weight. About one in every 5000 liposuction surgeries end up fatel.  But obesity brings in other lifestyle borne diseases too like diabetes and hypertension. Even cholesterol and chances of coronary heart diseases are higher in obese patients. You would die either way, is'nt it better to get the surgery where you have a one in 5000 chances of survival? Let us understand this with the next type of liposuction treatment.

Besides this there is bariatic sleeve and gastric bypass but I will not discuss about the same because the side effects are pretty similar. The purpose of this article is to help you understand why you should NOT opt for these procedures. 

2) Laser Liposuction: Now there are other procedures like gastric bypass, however, I will not get into the same because I really want to discuss Laser Liposuction and cool sculpting. 

These procedures is not even as much for obesity as much as it for aesthetics. These are more of a cosmetic procedure but I really want to discuss about the same. Vasar ultrasonic sound waves are first used to 'melt' the subcutaneous fat under the skin and then a pipe is used to remove the melted fat. You can look up cool sculpting, different concept to achieve similar results, I want to just discuss the side effects and both the procedures have similar side effects.

Cool- sculpting comes with a particular side effect called paradoxical adipose hyperplasia. Read the below to understand more:

How common is this? Not much, every one in 138 cases (ok I was being sarcastic, that's very common!)

Besides this, there are other obvious side effects of skin discolouration, uneven skin texture, saggy skin and potential scarring. But what no one really talks about is how the procedure just removes the 'subcutaneous fat'. 

Fat loss should come with the positive side effects of health gained. Even dropping as little as 15% body fat can reverse type 2 diabetes in upto 90% of people. Just losing a few pounds through diet alone can drastically impact our secretion of the hunger hormone Leptin that signals the body to stop eating when you are full. The same effect is observed when the body loses 'visceral fat'- the fat around the organs. Cholesterol starts to drop within as early as three weeks into a good fat loss program. 

Some of these benefits are observed with the first procedure temporarily but they are only observed due to caloric restriction post the surgery. Participants who undergo liposuction through stomach stapling are forced to drastically reduce their calorie intake to around 500 calories per day!

With VASER liposuction (or cool sculpting), you are still required to follow a healthy meal plan and exercise program post the procedure to maintain the fat loss, but this is even harder for people now because if you lose weight though fork and feet (diet and exercise), your hunger signals, metabolism, cortisol, hormonal fluctuations etc everything will improve. Health becomes your lifestyle and it becomes easy. You no longer have cravings, you naturally gravitate towards healthy food and live a fitter lifestyle. 

Post the procedure however you are like an obese individual trapped into a leaner body. You have not walked the path of fitness and it becomes too difficult to adapt now. There is no change in your insulin sensitivity, metabolism or other health markers. Over the first year, most people relapse to back and gain atleast half of the weight (if not more) they have lost and blame themselves for not being 'strict' enough with their regimen. But sweetheart, even if you work your very hard, with a sluggish metabolism you cannot absolutely expect your body to maintain your fat loss. 

The tad bit of subcutaneous fat under your skin is healthy for you and I am no one to say if you need a cosmetic procedure to get rid of the same. I am just trying very hard to explain you about not feeling guilty about gaining the weight back if it doesn't work.

With regard to the gastric bypass, I am strongly against the same and do not think you should live the rest of your life cutting calories or vomiting. Dedicate 6 months of your life towards making slow and consistent lifestyle changes (not dieting!) and choosing an activity you enjoy. You will be marvelled at how much your body can achieve. 

In conclusion. 

I really do not want this to be another article where I tell you to 'work hard' and 'eat less'. You have tried all of that (multiple times over probably). Instead, I suggest you hire the right experts to help you. Calorie restriction is not the answer so please do not fall for the same trap. The main problem with you is probably sticking to one routine for long enough. And then blaming yourself when you fall of the wagon. 

I spoke to a few people who went through liposuction and gastric bypass for this blog. I wanted their first hand experience on the same and had initially planned to include their audio clip for the same. The entire experience for me was an eye opener.

Everyone spoke about how they tried everything to lose weight and nothing worked for them. They mostly talked about their food addictions and how the surgery forced them to limit their food intake and completely drop alcohol altogether.

'I still love food and sometimes eat, knowing very well I will vomit' one of them said.

'I cannot travel for long distances because I cannot sit for longer than an hour, my back hurts constantly' another one said.

'My social life is limited because I cannot be around alcohol' was someone else experience.

But when I asked them if they would go back in time and redo it if they knew about the side effects, almost all of them said yes. I explained how if instead of being forced to diet now if they would only adopt positive lifestyle changes and drop alcohol before they could still lose weight, they all said

'that's true but I tried and I could not stay consistent'.

Makes me think, food addiction is a psychological disorder maybe. There is more than enough research about how obese people have less self control because of leptin resistance (the hormone responsible to tell your brain to stop feeding yourself) and other hormonal fluctuation. A simple dietitian's 'diet plan' does not fix this and doctors are not willing to invest time understanding the importance of hormonal balancing through lifestyle changes. So obese people do not really have much options left. They might follow a diet plan and have difficulty sticking with the same because of their hormones and not 'self- control' so think the surgery is the only option. 

Maybe hiring a motivational coach alongside a professional who understands that a fitness plan for obese individuals is different from a regular fat- loss program will help then. 

If you are reading this and considering liposuction, I want you to know that there are other ways to help you get in shape. It is just about finding yourself the right coach. Please do not blame yourself for not being able to stay on track, it's not your fault. 

Get in touch with me for a free diet consultation. If nothing, I promise to give you easy lifestyle modification tips to help you get started.  

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