The leader of India's main opposition party went under the knife this week to help him lose weight, throwing the spotlight on increasing use of surgery to tackle the country's growing obesity problem.The president of the Bharatiya Janata Party (BJP), Nitin Gadkari, is one of a rising number of Indians now opting for weight loss (bariatric) surgery to slim down.
Muffazal Lakdawala, Gadkari's doctor at the Centre for Obesity and Diabetes Surgery (CODS) at the private Saifee Hospital in Mumbai, said the political heavyweight was recovering well after his gastric bypass.
"He's fine. He's stopped his insulin" for his Type 2 diabetes, he told on Thursday.
The surgeon said that Gadkari, who tipped the scales at 130 kilograms (287 pounds), was morbidly obese - medically, someone with a body mass index of more than 40 - but that his weight should fall in coming months.
"He should tentatively settle at around 80 to 90 kilograms within a year or a year and a half," he explained.
India is traditionally more associated with malnutrition and chronic food shortages than overeating and weight-related illness, but economic growth has had an impact on waistlines, particularly in urban areas.
The boom has brought a more sedentary lifestyle, while being able to eat oil and sugar-rich foods, particularly Western fast food, is seen as a visible sign of status and increased disposable income.
Between 1998 and 2005, the number of overweight adults in India increased by 20 percent, according to an Organisation for Economic Cooperation and Development (OECD) study published in The Lancet medical journal last year.
Almost one in five men and more than one in six women are now overweight. In some urban areas, rates were as high as 40 percent, the study suggested.
Meanwhile, a separate study of 4,000 Indian children in 15 cities published last August indicated that almost a quarter (23 percent) of five to 14-year-olds in urban schools were overweight, while nearly 11 percent were obese.
Ramen Goel, a bariatric and metabolic surgeon at the state-run Bombay Hospital, blamed growing rates of obesity on lifestyle changes combined with a genetic predisposition among South Asian people to store more fat.
As a result, and due to greater awareness of the availability of the procedure, Goel's workload has increased drastically since he performed the first weight loss operations in India more than a decade ago.
At the turn of the millennium he carried out only about four procedures a year but that rate has now shot up to about 20 a month.
Likewise, Lakdawala said doctors at CODS carried out only one or two gastric bypasses a month when they opened in 2005 but now conduct about 30 a month. A number of their patients are politicians.
Gastric bypass surgery, such as Gadkari underwent, reduces the size of the stomach and length of the intestine that comes into contact with food, so the person eats less and absorbs fewer calories.
Other options include placing a gastric band around the stomach, which cuts the amount of food that can be consumed.
Lakdawala said that overweight and obese people were increasingly seeking surgery because a majority of them failed to shift excess body fat through diet and exercise.
But it also had other advantages, he said.
"This is the only surgery that can get rid of diabetes, hypertension, maybe uric acid and sleep apnoea all at once," he added, referring to conditions often associated with excess weight.
