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NEW DELHI — These days, real estate developer Prateek Sawhney ignores junk mail from plus-size stores. Instead, he shows off his slim physique with designer duds while sporting around New Delhi in a shiny green BMW.
Sawhney, 49, says he shrank his morbidly obese 350-pound frame four years ago after stomach bypass surgery helped him drop almost half his weight.
He now has become a self-appointed ambassador for bariatrics in India, as growing numbers of the country’s rapidly expanding urban population embrace stomach bypass and stapling surgeries to lose weight. As incomes have risen, so has obesity among an upwardly mobile middle class that is experiencing expanding waistlines along with wider food choices and is able to afford the procedure, which costs about $5,000.
About 18,000 weight-loss surgeries were conducted in India in 2014, up from 800 just five years ago, said Pradeep Chowbey, chief bariatric surgeon at Max Healthcare hospital in New Delhi and former president of the Obesity and Metabolic Surgery Society of India.
The procedure got an unexpected public relations boost recently when Indian Finance Minister Arun Jaitley had the surgery to control diabetes. He is one of three government ministers to have the operation.
“Seeing the prominent politicians undergoing this surgery has also boosted the perception that this is safe,” Chowbey said. “Now patients come to me and say, ‘I want what our finance minister had.’ ”
Experts say India suffers from the double burden of rising obesity and diabetes. The country has about 65 million diabetic patients, and about 80 percent of those cases are caused by obesity.
India’s obesity problem is an anomaly in a country where almost 270 million people live in poverty and one in two urban poor children are underweight.
But the rise of India’s middle class in the past two decades has unleashed a wave of unhealthy eating, including processed food, snacks and fast food. Several American burger chains, such as Johnny Rockets, Burger King and Carl’s Jr. — have opened in India in the past year — joining KFC and McDonald’s — to capitalize on what is being called India’s “burger revolution.”
The restaurant market in India was worth about $48 billion in 2013, and is projected to reach $78 billion by 2018, according to a study, “The Rise of the Quick Bite,” by consumer consulting group TechnoPak.
Doctors say the obesity rate among teenagers is alarming because they are addicted to junk food and gadgets and are not physically active.
“About 40 to 60 percent of India’s urban population is obese. It is a problem bigger than malaria and tuberculosis,” said Anoop Misra, chairman of the National Diabetes, Obesity and Cholesterol Foundation, and author of several recent studies on the problem. “America had this rising curve of obesity in the ’70s. That is where we are today in India.”
The number of neighborhood gyms and yoga studios have grown in India in the past two decades, but the country has few commercial diet programs such as NutriSystem or Weight Watchers and few nutritionists. Bariatric surgery has become the latest quick fix for those who can afford it.
“The challenge now is to alter the perception that bariatric surgery is merely cosmetic,” Chowbey said. “Obesity causes a metabolic storm inside you. It shortens your life, causes very high levels of diabetes and other hormonal changes. The surgery actually saves lives.”
India’s government now covers the cost of weight-loss surgeries for its 3 million government employees, making the procedure available for the not-so-rich as well.
But despite the rising number of surgeries, India lacks formal peer counseling groups, patients say. Eighty percent of the bariatric surgeons are working in smaller cities and nursing homes without adequate infrastructure and support programs, Chowbey said, and that raises the risk of post-surgery complications, largely because patients don’t make lifestyle changes that are necessary to maintain the weight loss.
His team is creating a cellphone app to educate patients before and after surgeries for obesity and diabetes.
Sawhney said he wants to set up India’s first formal support group for weight-loss surgery patients.
“Too many people are going into surgery without the training on how to cope with the aftereffects,” Sawhney said. “I want to walk them through the possibility of dramatic change in their lives but also tell them about the perils, without scaring them away.”
Experts predict that the booming $2 billion medical tourism industry in India will grow to include bariatric surgeries.
“There will also be a parallel growth in plastic surgery in India as bariatric surgery goes up, because body-contouring surgeries will become necessary to take care of the loose skin,” said Nidhi, 29, a lawyer who declined to give her last name because she didn’t want her surgery to be made public. She shed 165 pounds after an operation two years ago. Seven months ago, she married a man her parents found through an online Web site for arranged marriages.
“I could see the joy in my parents’ eyes every time they posted my post-surgery photo,” Nidhi said. “They got so many suitable matches.”
Sawhney, who had struggled with his weight since he was a teenager, was long heckled with words such as “elephant,” “fatty” and “sumo.” He took four insulin shots a day for diabetes. Diet and exercise regimens did not work.
“One day, I decided I wanted to shop in European stores and buy 34-inch jeans off the rack without having to call Levi’s for a custom-fit pair,” Sawhney recalled. “The plus-size stores that have opened in India now are just not fashionable. They are just boring grays, browns and blues.”
He learned about bariatric surgeries online, then became a member of the Weight Loss Surgery Foundation of America.
Two years, one bariatric surgery and several plastic surgeries later, he found his ideal body shape at 175 pounds.
“Many of my friends did not even recognize me,” Sawhney recalled. “I had to introduce myself to them all over again. It felt so good to see the look on their faces. It is a miracle. They think I am a hero.”