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Bariatric Surgery is Helpful in Obesity-related High Blood Pressure: Doctors

  • Bariatric surgery is done when a healthy diet and exercise haven’t worked or when a person is suffering from serious health problems due to obesity.

  • Obesity has reached epidemic levels today and has become a silent killer.

  • Losing weight can be crucial to controlling blood pressure.

  • Bariatric surgery is recommended for individuals with a BMI of 35 and above.

  • High blood pressure or hypertension can lead to kidney problems, besides heart disease.

Gastric bypass and other weight-loss surgeries are collectively known as bariatric surgery which involves making changes to the digestive system to help an obese person lose weight. Bariatric surgery is done when even a healthy diet and exercise haven’t worked or when a person is suffering from serious health problems like diabetes and hypertension because of his/her weight. While this is a ‘life-changing surgery for obese people, it has been found to be helpful in treating high blood pressure- one of the obesity-related health problems.

Obesity has reached epidemic levels today and has become a silent killer. More people are dying of obesity and related diseases than any other non-communicable disease. The World Health Organisation (WHO) defines obesity as excessive fat accumulation that presents several health risks. A Body Mass Index (BMI) over 25 is considered overweight, and above 30 is considered obese.

Dr Pradeep Joshi, MS M.Ch. (GI Surgery), Senior Consultant, Regency Superspecialty Hospital, Lucknow says that a healthy diet, more physical activity and less sedentary lifestyle are recommended to reduce blood pressure for people who are overweight or have obesity. “Losing weight can be crucial to controlling blood pressure. When diet change and exercise fail to bring long-term weight loss and sustained blood pressure reductions, then we recommend bariatric surgery. This surgery has shown benefits in both long-term weight loss and improved blood pressure, which can reduce the long-term, negative impact of high blood pressure on organ damage,” he says.

Besides heart injury and strokes, high blood pressure or hypertension can lead to kidney problems. Only a fraction of eligible patients are prescribed weight-loss medicine or referred for metabolic surgery. Bariatric surgery is recommended for individuals with a BMI of 35 and above, as per the guidelines of the Obesity and Metabolic Surgery Society of India (OSSI). In some cases, an individual with BMI of 30 and above is also eligible for this surgery in the presence of two associated diseases such as type 2 diabetes, high blood pressure, high cholesterol, etc.

Eligibility for bariatric or metabolic surgery is assessed after a complete clinical evaluation by the bariatric surgery team including checking blood pressure levels.

“A person undergoing eligible for bariatric or weight loss surgery is asked to adhere to a few vital instructions related to his/her diet prior to surgery. This may be for 7 to 15 days depending on the person’s clinical profile and weight. They are also asked to avoid foods rich in carbohydrates and encouraged to take foods rich in protein. It is best to avoid sugars. Smoking and alcohol intake must be stopped prior to surgery,” says Dr Pradeep Joshi.

Once a person undergoes bariatric surgery, they are asked to fast for 24 hours. During this period, they will be kept on intravenous fluids. They are kept on liquids for the first 15 days after the surgery. In stage 2, they will be on pureed foods for another 2 weeks. It is advisable to chew food well, eat slowly and in small portions.

In India, obesity has emerged as new health scare which needs to be tackled on an urgent basis. According to a report published in the Indian Journal of Community Medicine, presently India has more than 135 million obese people. The study also mentions that the country is under the double burden of under-nutrition and over-nutrition. On top of that, obesity-related blood high blood pressure is posing a new challenge amid the COVID-19 pandemic. Persistent high blood pressure can further increase the risk of several serious and potentially life-threatening health conditions like heart attacks, strokes and kidney disease. According to a recent study published in The Lancet, nearly one-third of Indians are already suffering from hypertension.

Bariatric surgery can offer many benefits but an individual must make permanent health changes to his/her diet and get regular exercise to help ensure the long-term success of this surgery.

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