The recent death of a 55-year-old woman in Meerut following bariatric surgery has ignited a debate about the safety and ethics surrounding this increasingly popular weight-loss procedure. While proponents tout bariatric surgery as a life-saving intervention for those struggling with severe obesity and related health issues, critics point to the inherent risks and the potential for complications, raising concerns about patient selection, informed consent, and the long-term implications.

Rajni Gupta, who weighed 123 kg, underwent bariatric surgery at a private hospital in Meerut. Her family alleges that the attending doctor promised a weight loss of 30 kg within 24 hours, a claim that the doctor denies. While her daughter, who also underwent the procedure, recovered well, Rajni developed complications, including a leak in her abdomen that led to a fatal infection. The family has accused the doctor of negligence, alleging that her post-operative pain was dismissed and that she did not receive adequate treatment.

Bariatric surgery, also known as weight loss or metabolic surgery, encompasses various procedures that alter the digestive system to limit food intake, reduce nutrient absorption, or both. Common types include gastric bypass, sleeve gastrectomy, and gastric banding. These surgeries are typically considered for individuals with a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health conditions such as type 2 diabetes, sleep apnea, or hypertension.

Bariatric surgery can offer significant benefits, including substantial and long-term weight loss, improved blood sugar levels and blood pressure, reduced joint pain, increased energy levels, and a decreased risk of death from heart disease, diabetes, and certain cancers. Many patients also experience improvements in their quality of life, with increased mobility, better sleep, and enhanced self-esteem. In some instances, bariatric surgery can lead to the remission or significant improvement of type 2 diabetes and other metabolic disorders.

However, bariatric surgery is not without risks. Potential complications include excessive bleeding, infection, blood clots, lung or breathing problems, and leaks in the gastrointestinal system. Longer-term risks can include bowel obstruction, dumping syndrome (which leads to diarrhea, nausea, and dizziness), gallstones, hernias, low blood sugar, malnutrition, ulcers, and vomiting. In rare cases, complications can be fatal. Some patients may require follow-up surgeries to correct complications or address excess skin after significant weight loss.

The case in Meerut highlights the importance of careful patient selection and thorough pre-operative evaluation. According to Dr. Ashish Gautam, a bariatric surgeon, surgery is safe "provided you follow a protocol of dos and don'ts that people need to know about". Bariatric surgery is not recommended for individuals with substance abuse issues. Patients with very high BMIs and severe medical conditions face the highest risk, though death can occur in any patient.

The rising popularity of bariatric surgery, fueled in part by social media, may lead some individuals to view it as a quick fix for weight loss, without fully understanding the risks and lifestyle changes required for long-term success. It is essential for healthcare providers to ensure that patients have realistic expectations and are committed to adopting healthy eating habits and regular exercise routines after surgery.

The debate surrounding bariatric surgery underscores the need for a balanced perspective. While it can be a life-saving option for some, it is not a magic bullet and carries inherent risks. A comprehensive approach that includes careful patient selection, thorough informed consent, skilled surgical execution, and dedicated post-operative care is crucial to maximizing benefits and minimizing potential harm.