‘I believe in the Circle of Life theory. It’s an ongoing life-cycle of learning, improving and teaching’
Team Optimist spoke with Dr Muffazal Lakdawala, Founder and Chief Surgeon, Dr Muffi’s Digestive Health Institute. The seasoned doctor discussed various aspects of present-day diet and obesity issues. Excerpts…
Team Optimist: What are the main causes of obesity? Is eating fast-food consistently one of the main reasons for it?
Dr Muffazal Lakdawala: Multiple factors cause obesity. The major reasons that increase obesity risk are a sedentary lifestyle, erratic eating patterns, consumption of high-calorie food or sugary drinks, lack of physical activity and hormonal imbalances. In some cases, genetics can be the reason for obesity, but, unfortunately, we can’t control that. However, the other factors can be controlled, monitored and maintained. Fast-food contains very high calories that get stored as fat in our bodies and will always be one of the biggest causes of obesity.
Team Optimist: What kind of a diet should growing children and teenagers follow to avoid obesity? Is packaged food the main culprit?
Dr Muffazal Lakdawala: Kids and teenagers are accustomed to sugary food nowadays. And home-cooked, traditional Indian meals have been replaced by fast-food. Most sugary food and drinks are readily available at the local store. Packaged food and juices contain high amounts of sugar. Teenagers with long college hours eat unhealthy canteen food, too, which can contribute to obesity. While consuming such food is a contributing factor to childhood obesity, lack of physical activity also plays an important part in weight gain. Instead of playing outdoors, taking part in sports, or even cycling, kids and teenagers are hooked on to their phones and videogames now, resulting in no fat burn and no energy consumption.
Team Optimist: Are bariatric surgeries risky? Can an obese person undergo such surgeries?
Dr Muffazal Lakdawala: Bariatric surgeries, when done at accredited centres with qualified and experienced surgeons, aren’t risky, at all. Nowadays, all bariatric surgeries are done through laparoscopy, which reduces the risk faced in an open surgery. Laparoscopic bariatric surgeries reduce the recovery period and also leave minimal, or no scars. In Asia, the BMI cut-off for bariatric surgery is 35, or higher. In some cases, a BMI between 30 and 35, along with co-morbid conditions, such as diabetes, hypertension, sleep apnea and so on, are also eligible for surgery. Bariatric surgery not only helps in weight loss, but also in remission of the co-morbid conditions, so improving quality of life.
Team Optimist: Many health institutes often claim to facilitate instant weight loss. Are those ventures risky? What precautionary steps should one take?
Dr Muffazal Lakdawala: While instant weight loss solutions can be an attractive short-term goal for many, they’re risky in most cases until medically supervised and not ideal for those suffering from morbid obesity. Instant weight loss procedures, such as those advertised, or detox/fad diets only work on some individuals and that, too, only for a short period. It also brings about various deficiencies that may be life-threatening, because they’re not sustainable methods. Sustainability is the key to any weight loss programme. Bariatric surgery is the only medically proven method for long-term sustained weight loss for morbid obesity.
Team Optimist: What’s the future of laparoscopic surgery in India? Do you think robotic surgeries are going to replace traditional laparoscopic surgeries in the near future?
Dr Muffazal Lakdawala: Laparoscopic surgery is conventional open surgery done in exactly the same way without giving you large, painful, ugly scars. You need advanced skill and training. Nowadays, you have many simulator training machines that can help surgeons practise and enhance their skills. Robotic surgery is laparoscopic surgery done via a robot, where a surgeon sits at the console and controls the robot with its multiple arms. It enhances vision via a 3D image and helps take away hand tremors.
I believe robotic surgery levels the playing field between skilled and not-so-skilled surgeons attempting laparoscopic surgery, but cannot replace those with exceptional finesse. The cost of robotic surgery in its current form is prohibitive, at least in India, where healthcare budgets are shrinking and has no role in the Ayushman Bharat Scheme.
In terms of the cost-benefit ratio, the extra cost of robotic surgery doesn’t provide additional safety, or enhanced patient experience in most cases of abdominal surgeries other than in some surgeries for prostrate and thorax. So, its uptake has been patchy and slow.
Team Optimist: Recently, you’ve been conferred the IFSO Worldwide Educator Award, 2019, at the 24th IFSO World Congress in Madrid. What’s your advice to young doctors working in the domain of weight loss and obesity?
Dr Muffazal Lakdawala: Bariatric surgery is an ever-evolving and challenging field, with developments coming in every day. It’s also a great field for research to challenge some age-old concepts of such diseases as diabetes, infertility, cancers and so on. I believe in the ‘Circle of Life’ theory. It’s an ongoing life-cycle of learning, improving and teaching. To me, one should constantly strive to learn more and should stop learning only when one’s dead.
What’s the value of education without having the ability to use it for the good of mankind? With knowledge also comes the responsibility of passing it on to the next generation. Medicine is a field where books can seldom teach what experience does. I believe that, if you’re blessed with talent, you ought to be teaching as long as you can for the youngsters to imbibe as much as they can before you hang up your boots.