The Terrible Rise of Bariatric Surgery
“The Baby Elephant Diet. A Modern Indian Guide to Eating Right”
In the city of Hyderabad where my organic farm is located, a giant billboard greets me every time I drive down the old airport road. The billboard is an advertisement for bariatric surgery, proudly shouting out to passersby ‘end your frustration’, and showing an obese person with a dumbbell in his hand. In the US, the number of people having this surgery is close to 200,000 a year; in India it is in the low tens of thousands but rising rapidly, especially with advertisements like this billboard in Hyderabad. There are several techniques in bariatric surgery, but basically what happens is that the stomach is stapled so that only a small pouch at the top of it is available for swallowing food. The small intestine is cut in half, and the bottom part of it is attached to this stapled stomach ‘pouch’.
Bariatric Surgery. The idea is to first reduce the stomach’s capacity, and second to cut the amount of time food spends in the small intestine (where sugars and fats are absorbed). Initially, following bariatric surgery, there is significant weight loss, and the symptoms of diabetes disappear. But the long-term effects are unknown, some leading doctors claim. ‘The way bariatric surgery is promoted as a “cure” for diabetes is unethical,’ says Dr Arun Bal, a diabetic foot surgeon and former editor of the Indian Journal of Medical Ethics. ‘It is a fairly new technique and we still don’t know its long-term effects on the body. This is a truly astonishing abuse of the human body and nature. Can you imagine the accumulated neglect of the body that gets you to a place where you need bariatric surgery in the first place? Sometimes the neglect is deliberate, but sometimes it is not.
Bariatric Surgery. After all who wants to suffer the consequences of an extremely risky operation like bariatric surgery, where people are known to routinely die on the operating table, and where the risk of complications and side effects is over 30 per cent. To make matters worse, this is just in the short term. We simply do not know what will happen after ten or twenty years but the prognosis is not good. Once you have this surgery, you can forget about the Baby Elephant Diet. You will no longer be able to eat fibre, because your stomach won’t be able to handle it. Your gut ecosystem would have turned into a swimming pool, kept clean only by chemicals. Your body will lose the ability to absorb vitamins and minerals as well, so you will have to get oral and intravenous vitamin shots. Essentially you will become a permanent patient of the healthcare system until the day you die. Can you guess in whose interest it is to get you into this state?
Fat Where It Is Not Supposed to Be Is the Most Dangerous Kind.
The neglect usually starts with a growing belly, the result of what doctors call visceral fat accumulation. By location, there are two major types of fat in your body, subcutaneous and visceral. Subcutaneous simply means that the fat is under the skin and spread throughout the body. This type of fat is less harmful. Visceral or ectopic fat means that the fat is wrapped around your organs and shows up as deep inside the belly, and makes the belly look big and hard. Visceral fat is highly dangerous, and is the predominant cause of all obesity-related illnesses. The good news is that different body shapes and types have different amounts of subcutaneous fat (and women have more than men), but this doesn’t have any negative health implications. On the other hand, visceral fat is largely diet and exercise related, so you can lose it more easily through diet (and gain it easily too through a poor diet).
Bariatric Surgery. Scientists have found that visceral fat is biologically active, meaning that fat cells produce hormones and interfere with body function, in a harmful way. We don’t yet know the exact mechanism by which this happens, but it is clear that fat cells increase the production of immune-system chemicals called cytokines, which raise the amount of chronic inflammation in the body. This in turn increases the production of cortisol and bad cholesterol (LDL). What we know about visceral fat is that the less you have, the healthier you are. The simplest measure of the levels of visceral or bad fat in your body is your waist circumference. For Indians, a man with a waistline over 37 inches (94 cm) and a woman with a waistline over 35 inches (89 cm), will have a level of visceral fat that is above the danger threshold.