Bariatric surgery or weight loss surgery is a surgery performed for obesity. This surgery helps reduce weight in obese people. This weight loss is achieved by reducing the inlet size of the stomach with a band, removal of portion of the stomach with or without re-routing small intestine.

Studies from various bariatric surgeons from all over the world has shown that weight loss surgery has caused significant weight loss over the long term. Also, bariatric surgeries have helped reducing blood sugar levels in diabetics and improve the overall cardiovascular health of obese people. Weight loss surgery is offered for obese people based on an index called body mass index.

Body mass index is an index calculated based on weight and height of an individual.

Body mass index is defined as weight in kilograms divided by square of the height in metres. Currently BMI is graded as

Less than 18.5 = Underweight

18.5 to 25 = Normal weight

25 to 30 = Overweight

More than 30 = Obese Class I

35 to 40 = Obese Class II

More than 40 = Obese Class III / Morbidly Obese

Obesity is increasing in the present era. Also, overweight and obese individuals are at increased risk of diseases like hypertension, diabetes, high cholesterol, heart attacks due blockage, disturbed sleep, polycystic ovarian disease, joint pain and some cancers like colon, breast and uterus. By offering surgery in obese patients, weight loss and control of above diseases can be achieved.

Indian scenario is a little different as compared to the western scenario. Studies have shown that Asian population have higher incidence of above diseases even at lower BMI. This has been studied and the possible reason is the basic difference in the body composition between Western and Asian population. Also, the fat composition is higher in Asian population as compared to Western population for a given BMI. Also, Asians in studies have shown to have elevated risks for hypertension, diabetes, and high cholesterol levels even for a lower BMI.

World Health Organisation has recommended BMI

Less than 18.5 = Underweight

18.5 to 23 = Normal weight

23 to 27.5 = Overweight

More than 27.5 = Obesity

Indications for Bariatric surgery are mainly based on BMI. The Asian specific guidelines in 2005 were

1. BMI > 37 Kg/m²
2. BMI > 32 Kg/m² with co-morbidities like Diabetes, high cholesterol, obstructive sleep apnoea
3. Failed attempts to lose weight through diet and exercise
4. Age between 18 years to 65 years