Anu Chakraborty, manager at a multinational bank in Calcutta, was facing a peculiar problem. Her most productive sales executive was threatening to quit. Not for a new job with a fatter pay cheque, but for one with a bigger chair. Sandeep Bose, the unhappy executive, was unable to use his office chair, owing to his massive girth. Chakraborty failed to get a suitable chair for him. Her office rules were clear: all seating for the employees had to be uniform.

Unwilling to lose a valuable colleague because of such a regulation, Chakraborty hit upon a novel idea. She arranged for Bose to undergo weight loss surgery, a radical solution not yet popular in today’s corporate world. Bose learnt he could expect to lose around 80 per cent of his excess weight in six months, enabling him to sit on any chair!

This is one example how Obese India’s increasing number of patients face unique problems in a society that is clearly not designed for size XXL.

The medical world, however, is getting its act together. Spurred on by the knowledge that 15-17 per cent of India’s populace is overweight or obese, and 30-50 per cent of urban citizens similarly plump, hospitals in metros and smaller cities are readying to cater to this new-age malady.

As innumerable studies have shown, obesity causes heart attacks, cancers, arthritis, lung problems, hernias, etc. The only scientifically proven solution is bariatric surgery, by which the patient’s capacity to eat and digest food is sharply restricted by using laparoscopic staplers or silicon bands.

Says Muffazal Lakdawala, chief of bariatric surgery at Mumbai’s Hiranandani Hospital, “A year ago, we used to perform one bariatric surgery a month. Today, we are doing four a week.” Pradeep Chowbey, chief of bariatric surgery at Sir Gangaram Hospital, New Delhi, states, “We see around 15 patients every week at our Bariatric Clinic”.

Apollo Gleneagles Hospital, Calcutta, launched its own Bariatric Clinic in June 2006. “We registered 42 patients in the first week at our obesity screening camp,” says Dr V.R. Ramanan, director of medical services at the Salt Lake centre.

Impressive numbers, these! So is a boom in bariatric surgery in the offing? “Yes,” says Lakdawala. Chowbey asserts that though a large number of people fit the bill for surgery, few actually turn up eventually, owing to the costs and low awareness of the ills of obesity. At Apollo Gleneagles, the number of screened obese patients does not convert to a comparable number of surgeries, thanks to most patients being in the ‘3U’ category: Unaware, Unwilling and Unable.

Hospitals are also eyeing the huge international demand for weight loss surgery. Almost two-third of the American population is overweight or obese. At Hiranandani Hospital, around 30 per cent of patients for weight loss surgeries are foreigners, mostly from the US. “We get patients who are either uninsured or need re-do surgeries for complications from previous operations like Lap Bands,” says Lakdawala.

Bariatric procedures at premier hospitals in India cost between Rs 2,50,000 and Rs 4,00,000. The costs are largely due to expensive equipment such as staplers. An average procedure in the US would be at least five times more expensive.

India is estimated to have around 25 million obese patients. Sixty to 80 per cent of these patients are diabetic and hypertensive or liable to become so. Twenty per cent of them suffer from heart disease. So how do our hospitals plan to tackle this emerging problem?

Wockhardt Hospitals, with centres in Mumbai, Bangalore and Calcutta, are planning to launch a bariatric programme “at the earliest”, informs Rupali Basu, general manager at the Calcutta hospital. “We already have the latest cameras and equipment such as Harmonic Scalpel and Ligasure,” Basu reveals. According to Ramanan of Calcutta’s Apollo Hospital, an obesity screening camp and patient awareness drive are going to be launched in the New Year.

Besides the major metro cities, smaller towns including Pune and Ahmedabad are running ambitious bariatric programmes. At Ludhiana’s Apollo Hospital, bariatric surgeon Arindam Ghosh has a scheme running for both Indians and foreigners. “When I get back to work in the New Year, I have three patients booked for surgery,” he says.

Compared to the US, the epicentre of Planet Obesity, where an estimated 1,60,000 bariatric operations were done in 2005, Indian hospitals are peddling small change.

However, with word-of-mouth publicity from successful cases and developing awareness, things are set to change. If experts are to be believed, the doubling of the incidence of obesity may result in India becoming the country with the largest number of obese people by 2025. Fat lot of good it would do to surgeons!

Dr B. Ramana is a Calcutta-based advanced laparoscopic surgeon and can be contacted on rambodoc@gmail.com