Dr Abhay Agrawal participates as panelist at the International Bariatric Surgical Meet

Dr Abhay Agrawal shared teaching inputs for the young surgeons with a take home message on safe bariatric surgery at Metasurg international bariatric surgical meet at Pune that attracted 500+ surgeons from India and 12 international stalwarts. Dr Agrawal was an invited panelist at the congress.

Don’t Forget Your Vitamins after Bariatric Surgery

Apart from diet and mild exercise, good supplementation would catalyse long-term weight and health success after Bariatric Surgery.

Patients after surgery may at times develop certain vitamin and mineral deficiencies in the long-run.

But, this risk can be very easily mitigated by following the supplementation plan as laid out by your surgeon.

One of the most common deficiencies is Vitamin B12 which is vital for the nervous system to function at an optimum.

The other key nutrients are Vitamin D and Calcium which are essential for good bone health and to prevent fractures and in the long haul osteoporosis.

Iron is another mineral which may be added to the list of requisite supplements.

Other vitamin supplements may or may not be added by doctors after an evaluation.

Patients often get complacent with taking the prescribed supplements on a daily basis with passage of time and due to early success of Bariatric surgery which is a magical experience for most patients.

A lifelong commitment to comply with your surgeon’s advice on supplementation will help you preserve and extend the success of surgery for life-time.

Building A Post Bariatric Exercise Plan

As you gear up to begin a new chapter in your life post your surgery, make exercise an indispensable part of your new life.

Here are some exercises that make up an all-rounded workout program:

Level 1

  • Once you have recovered from your surgery and have the go-ahead from your doctor, you can start off with some low-impact exercises.
  • Walking is the best way to begin. It is simple, cost-free and helps build stamina. Start with a short bout of 10 minutes and slowly build on the time.
  • Exercises like shoulder and arm rotations and leg lifts while sitting on a chair are a great way to mobilize the joints.

Level 2

  • About four weeks after surgery you should be able to increase the difficulty level, subject to your doctor’s approval.
  • Cycling is a great exercise at this stage as it is more challenging than walking but, at the same time it does not risk the joints.
  • Cycle outdoors or if the weather does not permit join a spinning class at the gym.
  • If the incisions have healed completely, you can add swimming to your exercise schedule.
  • Or, join a water aerobics class to add an element of fun and keep the motivation up.

Level 3

  • Once your body has got used to these exercises, it is time to add strength training to the mix.
  • Strength training helps build muscle mass which is effective in burning more calories, strengthening the joints and improving balance and posture.
  • Join a gym to do weight training under professional supervision and guidance.
  • Yoga is also a great way to incorporate strength training in your workout plan.

Remember to start slow and build up gradually at a pace that is right for your body.

Exercise well but most importantly exercise safe!

Power-Packed Bhel

With the rains around the corner, the taste buds will soon be calling out to the spicy, tangy chaats. But, the traditional chaats can create havoc in your diet plan with unhealthy ingredients.

However with this Bhel recipe, you can enjoy tasty chaat with no guilt.

Sunflower, watermelon and pumpkin seeds used here allow healthy snacking option.

Also, don’t underestimate the power of these little seeds.

Rich in Omega-3 fatty acid, they effectively help manage weight, blood glucose levels and other related health disorders.

These seeds are low in carbohydrates and high in healthy fats; and thus keep you full for longer and make you less susceptible to craving for unhealthy snacks.

A bowl of this Power-Packed Bhel, a cup of green tea and your favourite book or TV show may make for the ideal companions for a relaxed evening as the rain comes pouring down.

Ingredients (Makes 2 servings)

1/3 cup sunflower seeds
1/3 cup watermelon seeds
1/3 cup pumpkin seeds
2 tablespoons peanuts
¼ cup tomatoes, diced fine
¼ cup cucumbers, diced fine
¼ cup onions, chopped fine
1 tablespoon coriander leaves, chopped fine
1 tablespoon mint leaves, chopped fine
1 green chilli, chopped fine
Red chilli powder, to taste
Salt, to taste
Lemon juice, to taste

 

Method

  1. Make sure that the seeds and peanuts used are roasted but unsalted.
  2. Mix all the ingredients in a bowl and toss well. Serve immediately.
  3. Do not mix the seeds and almonds with the chopped veggies and seasoning too much in advance as the seeds will lose their crunch.

Bon Appetit!

Low Guilt Paneer Mutter Biryani

If rice is a staple in your meals, no worries!

Brown rice which is a healthier substitute to white rice cuts the risk of diabetes by 16%.

Unpolished red rice and black rice too are healthier choices compared to white rice.

This recipe of paneer mutter biryani maintains the traditional flavours of a biryani but ups the health value by using brown rice.

Low-fat paneer used here is a good source of vegetarian protein but should be consumed in moderation. It may also be substututed by tofu which is a plant-based source of protein and is thus a healthier option.

 

Ingredients

2 cups cooked brown rice
½ cup cubes of low-fat paneer
¼ cup green peas, boiled
1 onion, finely chopped
1 teaspoon chilli-garlic paste
½ teaspoon ginger, minced
1 green chilli chopped fine
½ cup tomato puree
½ teaspoon red chilli powder
½ teaspoon biryani masala or garam masala
½ teaspoon kasuri methi
Salt, to taste
2 tablespoons milk
Oil

 

Method

  • Heat 1 tablespoon oil in a pan and saute the onions till they brown slightly.
  • Add the chilli-garlic paste, ginger and chopped green chillies and saute for 1-2 minutes, stirring continuously.
  • Add the tomato puree, red chilli powder, biryani /garam masala powder and kasuri methi. Mix well and cook on a medium flame till the raw aroma of the tomatoes disappears.
  • Add 2-3 tablespoons of water, mix and continue cooking for 2-3 minutes.
  • Add the paneer cubes, green peas and salt and combine well. Cook until most of the water evaporates; the mixture should be semi-dry.
  • Add the rice and fold into the paneer and mutter mixture gently.
  • Add two tablespoons of milk and cook for 1 minute.
  • Serve hot.

Bariatric Surgery a Cost-Effective Approach: Says A Recent Study

Its natural that patients consider many factors before deciding to opt for the bariatric surgery route for weight loss.

One key factor is financial.

Cost of surgery includes a package of surgeon fee, other clinician fees, consumables, OT charges, room rent, medications, supplements, time away from work recovery period of about a week etc.

Thus, the question begs itself – Is bariatric surgery a financially viable option?

And, the answer is a resounding – Yes!

A recent study* carried out, which is among many such studies, analysed the cost-effectiveness of bariatric surgery as compared to the conventional approach of managing obesity and its co-morbidities through medication and lifestyle management.

The study took into consideration the cost of surgery, nutritional supplements, follow-up care and costs arising from any surgical complications.

The study concluded that bariatric surgery resulted in savings of around Rs 7.5 lacs (9332 Euros) over a lifetime!

In addition, an analysis of the data showed that bariatric surgery patients had 5 more quality adjusted life-years (QALYs) as compared to patients treated through the conventional medical approach.

Thus, when looked at over a period of 10 years, bariatric surgery proved to be more cost-effective. Secondly when compared for a lifetime, it was dominantly a more financially wise decision.

It is also important to keep in mind that bariatric surgery leads to remission of diabetes in majority of the cases and also has a positive effect on blood pressure, cardiovascular health and other health issues.

These are all comorbidities associated with obesity and require medical intervention in the form of consultations, drugs, frequent hospitalization and treatment for life.

Bariatric surgery involves a one-time costly procedure but when compared with the lifetime annual medical expenses incurred for those suffering from Type-2 diabetes and other obesity-related comorbidities, it proves to be a more cost-effective approach.

Hence, what are you waiting for? For a detailed consultation to find if you qualify for Bariatric surgery, please call +91 98210 32169 and ask for an appointment with Dr Abhay Agrawal. Patients with a BMI of 30 and above will get a free consultation on phone for 15 minutes.

*https://www.tandfonline.com/doi/full/10.1080/13696998.2017.1419958

Get Up and Get Going!

“I’ll start tomorrow” – is the most popular excuse to skip an exercise session.

But, in order to continue to reap the benefits of bariatric surgery, a light to moderate exercise routine will be of great help.

Here are some tips to help you make exercise a fun routine:

  • Workout buddy: Set up an exercise schedule with a friend whether it is going for a daily walk or enrolling in an exercise class. It may motivate you on those days when you are feeling lazy.
  • Choose your exercise: Opt for the kind of exercise that you enjoy. If you enjoy being out in the open go for a walk, if you enjoy dancing join an aerobics class
  • Mix it up: Don’t let it get monotonous and boring. Incorporating different exercises in your workout plan will keep it interesting and fun.
  • Change with the weather: Go swimming during summers and opt for indoor workouts during monsoons. This will ensure that weather conditions are never a reason for you to miss a workout.
  • Set targets: Working towards goals keeps the motivation up. Set weekly targets – increase the number of kilometres within the same time frame or doing more repetitions in the gym. This will make you push yourself harder every time.
  • Rest: Choose a rest day, maybe Sunday? Give your body a break and take it easy. It will charge you up to attack your exercise goals for the new week.

Post-surgery, exercise plays a crucial role in sustained weight loss, general fitness and optimum cardiovascular health.

Just like the proverbial “apple”, exercising daily too will keep the doctor away!

Cabbage and Soya Parathas: A Healthy Version of Your Favorite Food

Effective weight management is difficult short-term measures. It demands a overhaul of one’s lifestyle.

In order to stick with the long-term dietary changes, it is important to innovate to make healthier versions of your favourite foods, rather than sacrificing them all together.

In this recipe, soy flour is incorporated in the all-time universal favourite paratha to give it a nutritional boost. Soy foods can be an excellent addition to your diet plan. It contains isoflavones which are effective in bringing down blood sugar and improving heart health.

Besides being extremely nutritious, the addition of cabbage makes the paratha softer and more palatable and the addition of spices and condiments ensures that the flavour of this delicious treat is not compromised.

Ingredients

1 cups wholewheat flour

½ cup soya flour

2 teaspoons oil

½ cup grated cabbage

½ tablespoon grated ginger

Red chilli powder, to taste

1 teaspoon Dhania-jeera powder

1 green chilli, chopped fine (optional)

1 tablespoon coriander leaves, chopped fine

Salt, to taste

Oil, to cook (optional)

Method

Add 1 teaspoon salt to the cabbage and keep aside. After 10-15 minutes press the grated cabbage in the fist to squeeze out as much water as possible.

Combine all the ingredients and knead into a soft dough using water as required. Let the dough rest for 30 mins.

Divide the dough into equal balls and roll them into parathas.

On a tava, cook the paratha, flipping it to ensure it is cooked well on both sides.

Serve with low-fat yoghurt and vegetable / chicken curry for a complete meal.

Variation: Substitute cabbage with grated radish or chopped methi leaves for a different flavour.

Bon Appetit!

About Dr Abhay Agrawal:

Dr Abhay Agrawal is a world-class expert in all types of Bariatric and Diabetes surgeries: Mini Gastric Bypass, Roux-en- y Gastric Bypass, Sleeve Gastrectomy and Ileal Transposition (Diabetes Surgery). He is highly skilled with vast experience in advanced laparoscopic surgery. One of the few in India to offer 3D laparoscopic Surgery.

Dr Agrawal is among World’s first and few to be certified as International Surgeon of Excellence from the non-profit accreditation organisation from USA, Surgical Review Corporation (SRC).

He has treated more than 4000 patients with Bariatric and Diabetes Surgeries. His Bariatric and Diabetes Surgery program is well known for consistent and high quality results in long term weight loss and permanent cure for Type 2 Diabetes.  He personally treats every patient with out delegating it to juniors.

Dr Agrawal is available for consultations and surgeries at his own Center for Obesity and Diabetes Control (CODC) Malad East; SevenHills Hospital Andheri East; Apollo Spectra Hospital Tardeo, at Mumbai; and once a month at Kalda Hospital Raipur, India.

For appointments: Call or What’s app on +91 98210 32169 or Email at drabhay@gmail.com

Bariatric Surgery in Adolescents with Type 2 Diabetes Brings Positive Outcomes Says Study by Joslin Diabetes Center

Over the last 30 years, number of obese adolescents suffering from type 2 diabetes has dramatically increased globally as well as in India- which has earned a sordid reputation as Diabetes Capital of the World.

Half of this cohort who are severely obese end up needing insulin injections within a year of diagnosis, says Dr Lori Laffel, MD, MPH, Chief Pediatric, Adolescent and Young Adult Section at Joslin Diabetes Center who is a coauthor of the study published in March 2018 issue of Journal of American Medical Association (JAMA).

This study shows how Bariatric surgery could be a potential option for very obese adolescents with type 2 diabetes in lowering blood glucose levels, improving weight loss and returning cholesterol and blood pressure levels to normal.

The study compared 30 severly obese teenagers treated with type 2 diabetes medication with 63 teenagers who underwent Bariatric Surgery.

In those who underwent surgery, HBAIc dropped from 6.8 to 5.5 in two years. Whereas in those who received only medication, HBA1c increased from 6.4 to 7.8 in the same period of two years.

In addition, those who underwent surgery weighed 30% less in two years and those who were only on medication weighed 3.7% more.

Also significant improvement in blood pressure, cholesterol levels and kidney function is seen in surgically treated teenagers in this study group but not in those treated with medication.

If you have any questions on this study or type 2 diabetes problem with an adolescent at home, please feel free to schedule a telephonic consultation with us. Text us on +91 98210 32169 for 15 minutes of free telephonic appointment with Dr Abhay Agrawal.

Source: http://www.joslin.org/news/Obesity-Surgery-Linked-To-Positive-Outcomes-In-Very-Obese-Teens-With-Diabetes.html

Get Moving: Role of Exercise After Bariatric Surgery

First two years after Bariatric surgery are a dream-come-true phase where weight loss is almost automatic irrespective of whether you exercise or not.

Many patients get carried away in this magical phase and fall back on their old habits of overeating and not exercising.

Sure, damage is much less with Bariatric patients compared to those who haven’t undergone surgery with respect to weight regain.

Yet, there is a chance of 10-20% excess weight regain if healthy habits are not learnt after surgery i.e. mild to moderate daily exercise along with 6 small and healthy meals everyday.

Most patients are able to start off with moderate amount of exercise within two to four weeks of having undergone surgery. Make sure you consult your Bariatric Team to build the quantity and intensity of your workout based on your individual needs and condition.

Exercising ensures that not only do you continue to lose weight after surgery but also that you lose it the right way.

Most importantly, its much more fun exercising after surgery than before because results can be experienced much quicker and are more long-lasting.

Start slow, like a gentle 10-minute stroll and gradually build up the intensity to the point where you are left a little out of breath at the end of the exercise.

Low impact aerobic exercises like brisk walking, yoga, cycling, swimming, etc are a great way target the fat stores in the body. Also, include strength training in your workout plan to preserve and build the body’s muscle mass.

Exercising regularly ensures conditioning of the cardiovascular system and healthier joints. It also keeps the rate of metabolism up which helps sustain weight loss.

Exercising is also great for mental health. It infuses positivity and prevents stress and anxiety from bothering your mind.

Make sure that you listen to your body. Stop if it hurts. And, once your body gets used to the intensity, slowly up the ante and introduce new challenges in your workout.

So, strap on those boots and get moving!