MUMBAI, 8 DECEMBER, 2022 (GPN): A team led by Dr Aparna Govil Bhasker, Bariatric and laparoscopic surgeon, successfully helped a 120 kg woman lose weight through bariatric surgery at Apollo Spectra Hospital in Chembur, Mumbai. The patient who was diagnosed with PCOS-led infertility,  sleep apnoea, swelling on her legs, breathing issues and severe depression lost 38 Kgs after a laparoscopic sleeve gastrectomy. The lady is a proud and doting mother to two baby girls after weight loss surgery. She is working towards fitness and is leading a healthy lifestyle.

Mrs. Diana Kruz, a 33-years old lady from Mumbai with a corporate job was struggling with infertility for over ten years. She was diagnosed to have the polycystic ovarian disease (PCOD) along with menstrual irregularities. This resulted in gradual weight gain and despite all efforts to lose, the weight continued to rise. This coupled with multiple unsuccessful cycles of infertility treatment and scores of hormonal injections led to further weight gain. Gradually, her weight increased up to 120 kg, and she developed sleep apnoea, swelling in her legs and breathing issues. She felt trapped in her health issues and developed severe depression. She attempted multiple weight loss diets and explored various programs but could not lose weight. Every time she would lose a few kilos only to gain them back as soon as she went off the program. Finally, Diana consulted Dr. Aparna Govil Bhasker to explore the option for bariatric surgery with an objective to get back into shape and conceive a healthy baby.

Dr Aparna Govil Bhasker, Bariatric and laparoscopic surgeon at Saifee, Apollo Spectra, Namaha and Currae Hospitals, Mumbai said, “polycystic ovarian syndrome (PCOS) is a common hormonal disorder seen in women of reproductive age group.  Women with PCOS have enlarged ovaries that contain multiple small collections of fluid called follicles. They have high levels of male hormones called androgens along with increased insulin resistance and are predisposed to type 2 diabetes mellitus. Some of the common symptoms associated with PCOS are menstrual irregularities, acne, excessive body hair growth (hirsutism), insulin resistance (diabetes at times), thinning of scalp hair, and infertility as in the case of Diana. PCOS and obesity form a vicious cycle where PCOS leads to obesity and obesity, in turn, worsens PCOS. In addition to this, women who suffer from this dual problem face a lot of bias and stigma in the society. They are unfairly perceived as people with low will power and are blamed for weight gain and sometimes also for infertility.”

Dr Aparna added, “Weight loss is an integral part of the treatment of PCOS but it is also important to recognize that it is more difficult to lose weight for a person suffering from PCOS. Today, we know that diet is neither the only cause leading to weight gain, nor is it the only solution. Obesity is a multifactorial disease with very strong genetic and neuro-hormonal components. When it comes to treatment options, a healthy diet and lifestyle go a long way in the prevention of weight gain and to help those who are overweight. However, if the weight is higher and the person is already in the obese category (BMI > 27.5 K/m²), additional help may be needed. In addition to a healthy diet and lifestyle, weight loss medications, endoscopic weight loss procedures, or weight loss surgery (bariatric surgery) may be required as per the grade and severity of obesity.”

When Diana came to us, she was thoroughly evaluated and prepared for the surgery. We had a detailed consultation, conducted multiple tests, body composition analysis and then kept her on a high protein diet for 7 days prior to surgery. She had a lot of questions regarding pregnancy post bariatric surgery which were addressed by our team. She underwent a laparoscopic sleeve gastrectomy which entails the removal of the outer two-thirds of the stomach. This surgery takes about an hour to perform and the patient is discharged from the hospital within 48 hours. Patients lose about 70% of their excess weight over a period of 1 year. It also leads to a significant improvement in associated problems like diabetes, high blood pressure, heart disease, joint pains and PCOD etc. We routinely see great results in couples with obesity and infertility.

Women with obesity and infertility tend to conceive more easily after bariatric surgery. Even the results of artificially assisted techniques like IVF are much better.  Today, Diana is a happy mother to her two baby girls. She is also relieved of other issues like sleep apnoea, breathing issues, and leg swelling. Depression has been replaced with constant joy and happiness and she is presently working on losing the post-pregnancy weight gain.

Women who undergo bariatric surgery are advised to wait for 12 to 18 months to conceive. “This gives them enough time to recover as well as reach their weight loss target. Their food intake also gets much better after a year of surgery to be able to sustain the demands of pregnancy. It is advisable to see the bariatric team and run a battery of tests before planning pregnancy to rule out or cover any nutritional deficiencies,” highlighted Dr Aparna.

“10 years ago, when I was diagnosed with PCOD, I wasn’t aware that it can also induce obesity and infertility. My world turned upside-down when I was unable to conceive due to that excess weight because of PCOD. Over a period of time, I also developed other health problems that took a toll on me. I was depressed as I was desperately trying to conceive without any success. I constantly got unsolicited advice from people about weight loss along with fat shaming. This led to body image issues and poor self-esteem along with an unfulfilled wish of having a baby. I am eternally thankful to Dr Aparna G Bhasker and Ms. Mariam Lakdawala for helping me to lose weight, conceive without any complications, and give birth to two beautiful daughters,”  concluded the patient Mrs. Diana Kruz. Ends