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Resource centre on India's rural distress
 
 

India faces new epidemic with 60 million people morbidly obese by Robin Pagnamenta

India's economy may have been booming in recent years but so have the waistlines of those enjoying such dramatic growth.

As a result a country more usually associated with famine is facing an unexpected epidemic with 5 per cent of population 60 million people -- now morbidly obese.

This has kept bariatric (weight loss) surgeons such as Muffazal Lakdawala busy fitting gastric bands and stitching stomach bypasses for India's political and business elite. "We've operated on half the Cabinet," he said.

While 43 per cent of Indian children under 5 remain chronically malnourished, in big cities such as Mumbai obesity levels among adults are as high as 40 per cent. For those who can afford it, gastric surgery is viewed as a quick fix.

"It's a good business to be in," says Ramen Goel, a colleague of Dr Lakdawala, who estimates that about 2,000 such operations will take place in India this year, up from 10 in 2001.

This month Nitin Gadkari, the president of India's main opposition party, became the latest political leader to opt for the op.

The leader of the Bharatiya Janata Party and a type 2 diabetic who weighs 130 kilograms, Mr Gadkari underwent a gastric bypass last week.

"He is back at home now and he is fine," said Dr Lakdawala, of Mumbai's Centre for Obesity and Diabetes Surgery.

"It was a standard laparascopic procedure and it only took an hour."

Among Dr Lakdawala's recent patients at the exclusive Saifee Hospital, have been the ministers Nawab Malik and Nitin Raut.

D.Y. Patil, a ruling Congress Party MP, and several Bollywood film- makers and businessmen have also had a gastric bypass, an operation which trims the stomach, or gastric band surgery, where an inflatable device does the same job.

Manisha Talim, a weight loss expert, said that there was a growing trend, particularly among type 2 diabetics, 80 per cent of whom are obese, to opt for surgery.

"It's expensive and there are concerns about nutrition," she said.

"Still, surgery is becoming more popular, especially now there are more and more VIPs doing it."

But while gastric surgery is helping many Indians who are grappling with a serious weight problem, it has cast an unflattering light on the dizzying disparities of wealth.

Despite GDP growth of close to 8 per cent per year, a space programme and superpower aspirations, there are still more people living in absolute poverty in just eight Indian states 410 million - than in all 26 countries in sub-Saharan Africa.

At up to dollars $12,000 per patient, bariatric surgery is unaffordable for the vast majority of Indians, 700 million of whom still live on less than two dollars per day.

In Europe or the US, patients would have to pay $30,000 for the same treatment in a private clinic. Which helps to explain why Mumbai is emerging as an international centre for gastric band surgery, with hundreds of foreigners visiting every year for the treatment.

"Back in 2001 there were only two of us doing these operations across the country. Now we have about 50 bariatric surgeons practising in Mumbai and another 50 across India," Dr Goel said.

"We get quite a few international patients - from Africa and the Middle East too," added Dr Lakdawala.

"India would now rank No 1 in Asia for bariatric surgery, which is also the fastest growing field of surgery generally."

Just a few miles from Dr Lakdawala's clinic, it is a very different scene in Mumbai's Rafiq Nagar slum, a roughshod encampent of tarpaulin shacks and rubbish dumps. Last Year India's Integrated Child Development Services recorded at least 12 deaths from child malnutrition, and more than 2,000 children were considered malnourished.

THE TIMES, LONDON