A bariatric surgery is no longer considered a cosmetic weight loss procedure but a life-saving intervention for morbidly obese patients battling with medical conditions either caused by or related to obesity.
The wife of a Union government employee became the first person in the city to be reimbursed for a bariatric surgery under the Central Government Health Scheme (CGHS). Besides, a privately employed professional also received a full cashless cover from a public sector insurance company a few days ago. Both underwent bariatric surgeries at the Ruby Hall Clinic in the last week of May.
Thirty-four-year-old Manisha (name changed) weighed 99 kg at the time of surgery. She had a host of medical conditions like breathlessness even at slightest physical activity, loud snoring, pain in the knees, irregular menstruation, fatty liver disease, mood swings and episodes of depression. Besides, she was battling hormonal imbalances due to which she was unable to conceive. Manisha had attempted non-surgical weight loss programmes in the past but to no avail. She lost 5 kg in a week's time after the surgery. Her mood swings have gone down and her physical activity has increased. "I feel better, lighter and energetic. I have started going on regular walks which was not possible before the surgery," Manisha said.
Initially, Manisha and her husband faced hassles in availing of benefits under the CGHS. "Many empannelled private hospitals in Pune are not aware that bariatric surgery gets covered under the CGHS. We have a copy of the Union government's recently issued circular with specific guidelines to this effect. We had to get an approval from a government hospital for the surgery. So, we approached Sassoon general hospital which asked us to carry out some investigations and gave us permission after seeing the reports," Manisha said.
K M Vishwas, additional director of CGHS, Pune, confirmed that Manisha's claim approval for benefit under CGHS was indeed the first case of its kind in Pune. "The Centre's circular fixes criteria for availing of the benefit under CGHS. The benefit is extended on a case-to-case basis," Vishwas said. The circular was issued in November 2013.
The selection criterion is very stringent and only those with co-morbid conditions like uncontrolled diabetes, hypertension, osteoarthritis or back pain can avail of the benefit. "Those with no associated ailments are not considered for the cover," said another CGHS official.
Forty-two-year-old Anish (name changed), a resident of NIBM Road, was treated for an abdominal tumour in 2009. He weighed 120 kg. Anish continued to put on weight even after the treatment. He approached doctors again in April 2014 and was advised a surgery.
Anish presented with complaints like swollen legs, severe breathlessness even at rest, snoring to extreme extent, sleep apnea, severe backache restricting his physical movements. He was unable to sit properly and walk a few extra steps. On investigations, he was found to be pre-diabetic needing appropriate diet control which was a challenging situation in his case.
Anish's BMI was 62 and was operated upon at Ruby Hall Clinic on May 23 and discharged after three days. All his surgical expenses amounting to Rs 3.51 lakh were sanctioned by the New India Assurance Company. "It was a full cashless sanction," he said.
Anish has lost 30 kg in 15 days after the surgery. "I can sit and get up with ease and can walk considerable distance now. I am feeling lighter and more energetic," he said.
A person with a BMI of 30 and above is called obese. And those who have BMI of 40 and above are considered morbidly obese. "But in India, a person having a BMI of 37.5 and above is considered mordbidly obese as Indian population is found at risk of developing complications at the BMI of 37.5 and above. A person with BMI of less than 37 but with a host of other medical conditions can be advised to undergo bariatric surgery," said surgeon Jayshree Todkar, who treated Manisha and Anish.
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