Bariatric Surgery : A Cost Effective Treatment for Obesity IN INDIA

Bariatric surgery or gastric bypass is a type of weight-loss surgery often opted by patients to prevent life-threatening diseases caused by excessive weight. It is also known as metabolic surgery which makes changes in your digestive system to help lose weight.

The surgery is for patients with extreme obesity, body mass index over 40 or higher. Extreme weight is associated with complex health problems like type 2 diabetes mellitus, high blood pressure, sleep apnea and cardiac disorders. The guidelines laid by the medical association need to be met to qualify for bariatric surgery. 

It offers several advantages but success lies in effective management and post-care. Diet and exercise can effectively improve the results of bariatric surgery. Overcome the barriers by not only reducing food intake (restrictive methods like gastric banding or sleeve gastrectomy) but also altering the body’s hormonal environment (like with gastric bypass), promoting long-term weight loss and improvement of obesity-related conditions.

Nutrition in India is like a coin, malnutrition is one major problem in the country whereas the side of the coin says that we are third in the world in terms of obesity. Child obesity is a public concern, landing us right after China. Bariatric surgery is a safe option for extreme obesity. Here is a cost analysis of various types of surgery performed in India. Average cost is Rs. 250000 to Rs. 500000 depending on procedure and type of surgery. 

Why do I need bariatric surgery?

Bariatric surgery is done after enough efforts from your side to lose weight. The surgery reduces the risk of certain diseases.

Certain Cancers (Breast, Endometrial, and Prostate Cancer)

• Mechanism: Excess fat tissue produces higher levels of oestrogen, particularly in women. Elevated oestrogen levels are linked to an increased risk of cancers such as breast and endometrial cancer. Additionally, obesity-related inflammation and insulin resistance can promote cancer growth, particularly in hormonally sensitive tissues.
• Benefit of Surgery: Bariatric surgery reduces body fat and helps normalise hormone levels, thus lowering the risk for these cancers.

Heart Disease and Stroke

• Mechanism: Obesity increases the risk of atherosclerosis (plaque buildup in the arteries), hypertension (high blood pressure), and elevated cholesterol. These factors lead to coronary artery disease, heart attacks, and strokes. Inflammation and insulin resistance, common in obesity, further contribute to cardiovascular risk.
• Benefit of Surgery: Bariatric surgery can dramatically improve lipid profiles (lower cholesterol and triglycerides), reduce blood pressure, and improve overall heart function. This decreases the risk of heart attacks and strokes.

High Blood Pressure (Hypertension)

• Mechanism: Excess body weight increases the workload on the heart and blood vessels, leading to increased blood pressure. Hormonal imbalances, such as increased leptin and insulin levels, also contribute to this condition.
• Benefit of Surgery: By reducing body fat and improving insulin sensitivity, bariatric surgery helps lower blood pressure, often allowing patients to reduce or discontinue medications.

High Cholesterol Levels

• Mechanism: Obesity is linked to dyslipidemia (abnormal cholesterol levels), characterized by elevated low-density lipoprotein (LDL) cholesterol, low high-density lipoprotein (HDL) cholesterol, and high triglycerides. This condition accelerates the risk of cardiovascular disease.
• Benefit of Surgery: Significant weight loss can normalize cholesterol levels by reducing LDL and triglycerides while raising HDL cholesterol, contributing to better cardiovascular health.

Nonalcoholic Fatty Liver Disease (NAFLD)

• Mechanism: NAFLD is the accumulation of excess fat in the liver, which can progress to NASH, where the liver becomes inflamed and damaged. Obesity, insulin resistance, and high levels of free fatty acids promote fat deposition in the liver.
• Benefit of Surgery: Weight loss through bariatric surgery improves liver function and reduces fat accumulation in the liver. It may also prevent the progression of NASH to more serious conditions like liver cirrhosis or liver cancer.

Sleep Apnea

• Mechanism: Obesity leads to excess fat around the neck and upper airway, which can obstruct breathing during sleep, causing sleep apnea. The condition is linked to severe complications like hypertension, heart disease, and daytime fatigue.
• Benefit of Surgery: Weight loss reduces fat around the airway, significantly improving or resolving sleep apnea in most patients.

Type 2 Diabetes

• Mechanism: Obesity is the leading cause of type 2 diabetes, characterized by insulin resistance and inadequate pancreatic insulin production. Excess fat tissue releases free fatty acids and inflammatory cytokines that impair insulin action.
• Benefit of Surgery: Bariatric surgery has profound effects on insulin sensitivity and glucose metabolism. Many patients experience remission of type 2 diabetes within weeks after surgery due to the weight loss and hormonal changes that surgery induce.

Bariatric surgery is a powerful tool to reduce obesity and associated diseases by directly addressing both the mechanical and hormonal imbalances that contribute to these life-threatening conditions.

What are the types of bariatric surgery performed in India?

In India, several types of bariatric surgeries are performed to help individuals with severe obesity achieve significant and lasting weight loss. These procedures are typically classified into restrictive, malabsorptive, or a combination of both. Here are the main types of bariatric surgeries performed:

Roux-en-Y Gastric Bypass (RYGB)

This is one of the most common and effective procedures in India. It involves creating a small pouch from the stomach and connecting it directly to the small intestine, bypassing a portion of the digestive tract. This limits food intake and reduces nutrient absorption, promoting significant weight loss. It is particularly effective in resolving diabetes and other metabolic disorders.

Sleeve Gastrectomy

In this procedure, about 75-80% of the stomach is surgically removed, leaving a small, tube-shaped stomach or “sleeve.” The reduced stomach size limits food intake and significantly reduces the production of the hunger hormone ghrelin, helping patients lose weight. Sleeve gastrectomy is widely performed in India due to its lower complication rates compared to other surgeries.

Adjustable Gastric Banding (AGB)

Also known as “lap band” surgery, this procedure involves placing an adjustable silicone band around the upper part of the stomach to create a small pouch. The band restricts the amount of food that can be eaten at one time. It is a reversible procedure, but its use has declined in India due to less predictable weight loss outcomes compared to other bariatric surgeries.

Biliopancreatic Diversion with Duodenal Switch (BPD/DS)

This is a more complex procedure that combines both restrictive and malabsorptive techniques. A portion of the stomach is removed (similar to sleeve gastrectomy), and the small intestine is rearranged to bypass a large portion of it, reducing the absorption of calories and nutrients. It is highly effective for weight loss but is less commonly performed in India due to its higher risk of complications.

Mini Gastric Bypass (MGB)

A relatively newer procedure in India, the mini gastric bypass involves creating a long, narrow stomach pouch and connecting it to a loop of the small intestine, bypassing a portion of the digestive tract. It is less invasive than RYGB but still provides effective weight loss and metabolic improvements, especially in individuals with type 2 diabetes.

These surgeries are performed in leading hospitals across India, offering patients effective solutions for managing severe obesity and its related health conditions.

Various types of Bariatric Surgery cost in India

Average cost of the treatment varies from Rs. 2,80,000 to Rs. 6,00,000 depending on the various factors. Here is a comparison of the cost of different types of bariatric surgery. 

Above numbers depict average cost of the procedure which can vary considering pre and post procedures including follow up. AI-Afiya Medi Tour helps patients to find the best possible treatment keeping in mind the cost and care you desire! Talk to our experts via clicking on the button on the website. 

What are the factors that influence the cost of bariatric surgery?

Type of Surgery

The cost varies based on the type of bariatric surgery performed, with procedures like gastric bypass and BPD/DS typically being more expensive than adjustable gastric banding or sleeve gastrectomy.

Hospital Facility

The reputation and accreditation of the hospital or medical centre play a role, with higher-end, multi-specialty hospitals charging more due to advanced facilities and services.

Surgeon’s Expertise

Experienced and highly qualified surgeons usually charge higher fees. The complexity of the procedure may also affect the surgeon’s fees.

 Geographic Location

Bariatric surgery cost in india  can differ widely depending on the city or region, with metropolitan areas like Mumbai, Delhi, and Bangalore generally having higher rates than smaller cities.

Pre- and Post-Surgical Care

Costs also depend on the comprehensive care package, which may include consultations, diagnostic tests, nutrition counselling, and follow-up care for months after the surgery.

 Insurance Coverage : Insurance plans in India may cover part or all of the surgery, significantly affecting out-of-pocket costs. The extent of coverage depends on the specific health policy. 

What is post-operative nutrition and management?

After bariatric surgery, nutrition becomes a key element of long-term success. While it’s natural to wonder if you can return to “normal food,” it’s essential to redefine what normal means in the context of your new lifestyle. The focus should shift to nutrient-dense, smaller portions to ensure that your body gets the vitamins, minerals, and protein it needs while adjusting to the smaller stomach capacity.

Bariatric surgery decreases the portion of your regular meals. The challenge is to complete your daily nutrition. Right after the surgery, your diet will include more liquids to prevent dehydration and protein to build the body muscle. This helps your digestive system heal and adjust to the changes from surgery. Each phase emphasises high-protein, low-sugar, and low-fat options. As time passes, you can focus on other nutrient requirements such as minerals and vitamins. Nutrition after the surgery is a game of moderation. 

Since your stomach can only hold small amounts of food, prioritising protein is crucial. Protein helps with healing, muscle preservation, and overall energy levels. Avoid foods that offer little nutritional value, like sugary snacks, fried foods, and soda. These can lead to nutritional deficiencies and jeopardise your weight loss goals.

The journey doesn’t end with the surgery—it’s a lifelong commitment to healthy eating habits. Regular meals with balanced portions, mindful eating, and an emphasis on nutrient-dense foods will help you achieve and maintain your weight loss goals while supporting overall health.