Obesity to surpass all diseases in coming years: Dr Sumit Talwar

Dr Sumit Talwar, the head of the Department of General & Minimal Access Surgery and the Chairman of Bariatric Surgery at Manipal Hospitals, India, spoke on a seminar on obesity at The Daily Samakal office in the city recently.

Soon after the seminar, Dr Sumit Talwar was interviewed on the same issue by Mohammed Humayun Kabir, Senior Sub-Editor of The Daily Samakal.

Here is the interview:

Samakal: Very nice to meet you. We would like to hear shortly about yourself.

Dr. Sumit: I am Dr Sumit Talwar. I have done my graduation and post graduation from All India Institute of Medical Sciences, New Delhi. And I am practicing surgery for more than 45 years and I am practicing bariatric surgery for more than a decade. I am the Head of the Department of General & Minimal Access Surgery and the Chairman of Bariatric Surgery at Manipal Hospitals, India. 

Manipal Hospitals is a big chain of hospitals which has 14 hospitals all over the country and Malaysia and Nigeria. We are combined capacity of more than 6,000 beds. Manipal Groups started with medical colleges in 1950. And the medical colleges are consistently ranked between the top 10 medical colleges in the whole of India, including government and private medical colleges. Manipal Hispitals, Bangalore has been ranked as the top hospital in Bangalore for the past 15 years continuously. We treat about 30,000 to 40,000 patients in India, OPD, in every month in our hospital. Out of which, almost there are 4,500-5,000 Bangladeshi nationals which come to Manipal as new patients every month. We have everything from Dental surgery to liver transplant and heart transplant. The oncology, orthopedics, pine and bariatric surgery are centre of excellence.

Samakal: Do you have any statistics that how many people of Bangladesh go to your hospital in India?

Dr. Sumit: Yes, we have some 35,000-40,000 OPD patients in a month.  I just told you 4,500 to 5,000 new registrations from Bangladesh alone, we see in the OPD. There are some 80-90 countries from which patients come to India, to Manipal to get treatment. I am not sure on the exact number of patients come from outside to get treatment. But it is a substantial number.

Samakal: Is there any liaison or link with a hospital in Dhaka?

Dr. Sumit: As I know we have no link with any hospitals in Bangladesh. We are partner with Global BD and we are opening an information centre in Dhaka. I am not sure if we have any plans of making a hospital or running a hospital in the near future. Yes, we are always looking forward it but I don't know if there is a plan which is going on.

Samakal: What is the current scenario of obesity around the world?

Dr. Sumit: It is the beigest epidemic of this century. It is going to be the biggest killer of human beings. Out of all diseases, it has surpassed cancer, heart disease; it will surpass everything in the next five, ten, fifteen years. In the US and the Europe almost 35% to 40 % people are obese. And almost 10% to 15% people are need of the bariatric surgery. In our part of world also, almost 10%-15% of the urban people are obese and about 5% of them need surgery. So, if you combine all the people of South Asia, they are may be 2,00 crore of people. If we calculate 5% of 200 crore, these are the patients who need bariatric surgery.

Samakal: What about obesity and children?

Dr. Sumit: Obesity in children is also dangerous. It is harmful for them. I have seen children who become diabetic at the age of 10, 12, 14 years because of obesity. They are the people who will benefit from surgery even though they are children and they are growing. If we are more careful in them, we are more careful about the supplements and protein supplements because they have substances to grow, they have to become bigger. 

Samakal: Relations between obesity and mental health?

Dr. Sumit: Very difficult question. They are interrelated in both ways. There are certain psychiatric disorders, mental disorder due to obesity. So, those people become obese because of overfeeding. They are the patients who will not probably benefit from bariatric surgery unless their psychiatric disorders are treated first. On the other hand, obesity itself causes mental issues, there is lack of confidence, there is depression, and there is anxiety. It has been shown that the performance in the workplace is reduced in the obese people. Once they undergo bariatric surgery their performance improves. They have social issues; they are usually shy, lot of people makes fun of them, and even their family life is also disturbed. Their desire, their performance everything is reduced.

Samakal: What types of cancer causes due to obesity?

Dr. Sumit: It has been seen that in obese people the rate of getting breast cancer, prostate cancer, and colorectal cancer is higher than the normal population. We are pretty certain that it is relative to obesity somehow. 

Samakal: Does economic loss cause for obesity?

Dr. Sumit: Yes, absolutely. There was a very good study in the West which was done and found that the obese people are less likely to retain a job. People with similar qualifications, who are not obese get job. So the obese people are more likely to be throwing out of their job. So economically, it is a very harmful disease.

Samakal: What steps can a government take in this regard?

Dr. Sumit: In the subcontinent, I think, or all over the world, the first thing is to cut down the amount of sugar that is available to children. You would be surprised to know how much sugar there is in a bottle of coke. In a bottle of coke of 330 ML, there would be enough sugar for satisfying our sugar requirement. Sugar is so addicting. The first thing is that to restrict the availability of sugar to children. That we should start soon. There are some countries which have put sugar tax. That means they made the soft drinks and cold drinks more expensive as they put more tax. So, we should look at this. Reducing sugar, carbohydrate in out diet, increasing protein in the diet and promoting outdoor activities those are the most important things that we have to do to prevent obesity. And not only children, their parents also have to be aware of it. Because, the children also follow whatever their parents eat. If I am drinking coke all the whole day, so how can I tell my son or daughter not to drink coke. First, I have to stop and only then the children will stop to consume those.

Samakal: The number of obese people in the third world countries is increasing than the first world countries. Why?

Dr. Sumit: We are suffering from a double nutritional problem. On the one hand, we have malnutrition in which children are not getting enough food. And on the one hand, the same category of people in the lower middle class, in the lower income of strata, people are becoming obese. The reason is that as compare to the past, may be 15 years ago, we still have much better availability of food. Now people won't go hungry or without food that easily as it was happening 15 years ago. The other thing is the cost of things. It is always easier to get rice and fill our stomach with rice. And the other thing is evolutionary, million years ago, when we are in the jungles, we are very little to get food. And our bodies have been designed to survive on little. Now we have so much food available to eat and that our body cannot handle it; it just stores extra foods whatever it gets. That is the reason we are getting obese.

Samakal: The longer the belt, the shorter the life - What do you think?

Dr. Sumit: Absolutely correct. I think the elegant words - The longer the belt, the shorter the life - there is no doubt about that. It has been seen shown again and again that obese people live at least five to 10 years less than thin people - there is no doubt about that.

Samakal: So, should we be very careful regarding obesity?

Dr. Sumit: Yes.

Samakal: Thank you very much.

Dr. Sumit: Thank you.