Bariatric Surgery in India

Bariatric surgery is a group of weight-loss surgeries that involves making changes to the digestive system, some of which are non-reversible. The idea behind these types of surgeries is to help patients lose weight by either limiting the amount of food they can consume/digest at any one time or reducing their body’s ability to absorb nutrients. Some procedures do both. 

Bariatric surgeries should only ever be the final option when diet and exercise have proved inadequate and there are now serious health concerns caused by a person's weight. In general, these surgeries can only be an option for patients whose body mass index (BMI) is 40 or higher (extreme obesity). In certain cases, patients whose BMI is 30 to 39.9 may qualify for certain types of bariatric surgery if they have serious weight-related problems, such as type 2 diabetes.

The three most common types of Bariatric Surgeries are as follows:

1. Gastric Sleeve – The most common surgery, in which about 80% of the stomach is irreversibly removed, resulting in a sleeve or tube-like structure. This smaller stomach will not be able to hold as much food and produces less of the hormone that regulates appetite (ghrelin), which can lessen the patient’s desire to eat. 
2. Gastric Bypass – A more complicated procedure in which the stomach is divided into two parts; a small upper pouch and a large lower ‘remnant’ pouch. The small intestine is rearranged to bypass the large pouch. As a result, the volume of the stomach is significantly reduced. This causes food to go into the small upper pouch of the stomach and then directly into the small intestine. The small upper pouch can only hold around an ounce of food. Gastric Bypass is typically not reversible. 
3. Gastric Band – Involves an inflatable silicone device that is fitted around the top portion of the stomach to create a smaller stomach pouch. This procedure causes the patient to feel fuller with less food but still allows the body to digest food as usual, without malabsorption. The device can be removed when the patient reaches their desired weight.

The bariatric surgeries mentioned above are typically performed laparoscopically, in which the surgeon creates around one to five small incisions in the abdomen to insert a laparoscope (a long narrow tube with a camera) and surgical tools. The patients are usually given a general anesthetic, so they will not feel anything throughout the surgery.

How Long Should I Stay in India?

After bariatric surgery, an overnight stay in the hospital is usually required. In some cases, you may need to stay longer (around 3 to 5 days). However, it is not advisable to leave India as soon as you are discharged from the hospital. Stay at least 10 to 14 days following your surgery for initial recovery and follow-up checkups. During the follow-up checkups, your surgeon will remove your stitches and check your overall condition.

What's the Expected Recovery Time?

The recovery time may take around 3 to 6 weeks until you are allowed to go back to your normal activities, including work, with some restrictions. You must avoid heavy work and strenuous activities, such as lifting, pushing, or carrying heavy loads for at least the first three months after surgery. You should also avoid sitting and standing without moving for long periods to avoid blood clots forming in your legs.

What Aftercare is Required?

You will be given a special diet plan immediately after your surgery, as well as detailed post-operative instructions. Make sure to follow the diet plan and instructions to avoid complications and speed up your recovery. In order to maximize and maintain weight loss, it is important that you commit to healthy eating and regular exercise. There may be restrictions on how much food you can consume. You may also need to change your eating habits, such as eating 6 small meals instead of 3 large meals each day. You should take vitamins and mineral supplements to ensure proper nutrition. 

What's the Success Rate?

The success rates vary for each of the different types of bariatric surgery. In general, within the first six months following the surgery, most patients lose around 30% to 55% of their excess weight. Then, as early as 12 months after surgery, most patients lose over 70% of their excess weight. Patients could also maintain a 50% to 60% loss of excess weight for 10 to 14 years after their bariatric surgery. Although the success rates are high, there are risks associated with bariatric surgery, such as bleeding, deep vein thrombosis, infections, spleen injury, stenosis, and infections.

Are there Alternatives?

There is a non-surgical Bariatric procedure, known as the Gastric Balloon. This involves an inflatable device that is temporarily inserted into the stomach via endoscopic placement. A sizable area of the stomach is obstructed by the balloon or balloons, thus reducing the amount of food it can contain at any one time, leading to eventual weight loss. The balloons are usually removed after 6 or 12 months. 

If you cannot or do not want to undergo any surgery or medical procedure, you may be able to work with a doctor who is experienced in treating extreme obesity and a dietician as the alternative. They may recommend you to change your diet, adding physical activity, and prescribe medications.

Bariatric Surgery in and around India

About India

As the largest country in South Asia and the seventh-largest in the world, India is home to over one billion inhabitants. This extremely diverse country boasts one of the world’s fastest-growing economies and with its 38 JCI accredited facilities, it’s considered a prime destination for Medical Tourism. India welcomes an ever-increasing number of medical tourists each year, many of which travel for Bariatric Surgery procedures. Its low-cost medical procedures draw tourists from all over the world, particularly Western and Middle Eastern countries. Highly specialized doctors speak English and the vast majority are trained in the UK or the US, with heart surgery procedures being especially common in India. Local accreditation bodies include the Indian Healthcare Federation, the Indian Medical Tourism Council, the Ministry of Health and Family Welfare, and the National Accreditation Board for Hospitals & Healthcare Providers (NABH)

Popular Parts of India

Home to around 1.3 billion people, India is the second-most populous country in the world, with its multi-ethnic society, spiritual beliefs, architecture, and diverse wildlife.

• Delhi is brimming with colorful modern life and is steeped in history. It is known to have the best food in the world such as Mughalai curries and chaat (vegetarian street food). Visit the Red Fort and witness the fascinating structure influenced by Islamic, Hindu, Persian, and Timurid traditions.
• Mumbai is the most cosmopolitan city in India. Home to Bollywood, India’s film industry, the city has a lot to offer. Stroll around the Gateway of India, shop in Colaba Causeway, watch the sunset in Marine drive, or visit Siddhivinayak Temple and learn about its cultural history.
• Kolkata (Calcutta) was once the capital city of India. It is a perfect blend of the past and the present. The city has charming colonial-era architecture, dynamic suburbs, and the amazing Bengali cuisine. Tourists can discover the creativity of Kurmatuli Idol-makers and visit the incredible Victoria Memorial.
• Jaipur is known as “The Pink City,” it is chaotic, vibrant, and historical.  The city, along with Delhi and Agra, is a part of the Golden Triangle that contains the biggest attractions in India. There are many beautiful buildings inside this city, but the most visited one is the Amer/Amber Fort that dates back to Raja Man Singh. It is a World Heritage Site and it offers amazing views of the city.
• Agra is where the magical Taj Mahal stands. The UNESCO World Heritage Site is as astounding as people describe it to be. Mehtab Bagh is another must-visit attraction; it offers the most scenic spot in the city and located just across the river from the Taj Mahal. Agra Fort, located northwest of the Taj, is one of India’s most historic structures.

Weather and Climate in India

There are four climatological seasons in India.

• Summer or pre-monsoon season starts in March and ends in May. April or May is the hottest month. The average temperature is around 23 to 42 °C.  
• Monsoon or rainy season lasts for three months from June to September. The season is usually humid and rainy. South India usually receives more rainfall.
• The post-monsoon or autumn season starts from October to November. The sky is usually cloudless.
• Winter occurs from December to February. December and January are the coldest months in the country with an average temperature of 10 to 15 °C and climb steadily from February. This is the peak season for tourism.

The best time to visit India is in the month of March or October when the weather is warm and sunny.

Getting Around in India

Indira Gandhi International Airport is the busiest airport in the country and is located in Delhi. The airport serves domestic and international flights. It connects the city with almost every country around the world and serves budget airlines such as Air Asia India, Go Air, and IndiGo. There are three other main international airports in Mumbai, Chennai, and Bengaluru.

The most affordable way to travel around the city is by bus although it can be very crowded. Buses are very reliable and fast. Airport taxis are available as a quick, easy, and hassle-free transportation mode especially for tourists who carry big baggage.

The best way to get around India is by train. Trains are everywhere and quite affordable with many different classes. The most popular class for travel is the Sleeper Class. It is best to purchase train tickets online.

Buses are a nice option for short-distance travel. Some of the buses can be very uncomfortable but there are luxury buses with air conditioning. Tourists can purchase tickets online, in the station, or even on the buses.

Taxis are relatively affordable, but tourists have to bargain. Tourists can ask the taxi driver to use the meter but the drivers will usually say it’s broken. It is advised to ask your hotel or hostel how much a taxi should cost before getting in one to avoid getting ripped off by taxi drivers. Rickshaws (Tuck-Tuks) are cheaper than taxis, but you also have to bargain. Hiring a car is not recommended due to the lack of respect for traffic laws and the chaos on the roads. Uber is available.

Tourist Visas in India

All visitors need to obtain and apply for a visa to enter India, except the citizens of Nepal and Bhutan. Visa on Arrival is available for citizens of Japan and South Korea. The country provides an online visa application. e-Visa is available for 150 nationalities and valid for  60 days. It is a double-entry visa. There is also a six-month tourist visa for longer trips.

Passport must be valid for at least 180 days after your entry to India and should have at least two blank pages.

Additional Information

1. Local Currency: the official currency is the Indian rupee (INR). 1 USD is equivalent to 70 INR.
2. Money & Payments: ATMs are widely available. Currencies such as US dollars, euros, and pounds sterling are easy to change throughout the country. Credit and debit cards are accepted in some shops, restaurants, and hotels. Always carry cash because many places still accept cash only. Service fees are sometimes added to the bills automatically in restaurants if it’ 10% tip is reasonable. Taxis and rickshaws do not expect a tip but it is good to tip drivers who are honest.
3. Local Language: There are many languages spoken in India including Hindi, Bengali, Telugu, Marathi, Tamil, Urdu, Gujarati, and Punjabi. English is understood by many people especially those in the tourism area and major cities.
4. Local Culture and Religion: India is very diverse and multicultural. Hinduism is the largest religion with 79.8% of the population practicing the religion. Islam, Christianity, Sikhism, and other religions are also practiced.
5. Public Holidays: India celebrates several major religious holidays. The country has numerous annual festivals such as Holi, Ganesh Festival, Diwali, and Onam.