SINGAPORE - Many people assume bariatric surgery - which reduces the size of the stomach and/or its capacity to absorb food - is only for weight loss. But it can also improve diabetes and other risk factors for cardiovascular disease.
Dr Shanker Pasupathy, 42, learnt this during a one-year fellowship in advanced laparoscopic and robotic surgery in France and was spurred to pursue bariatric surgery.
After returning to Singapore, he was the first to perform some complex and minimally invasive procedures in SGH, including laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass.
A sleeve gastrectomy removes two-thirds of the stomach to reduce food intake, while a Roux-en-Y gastric bypass creates a small stomach pouch and connects it directly to the middle of the small intestine.
Today, he is the director of the Life Centre and senior consultant at the department of vascular surgery at Singapore General Hospital (SGH).
Dr Pasupathy is also president of the Obesity and Metabolic Surgery Society of Singapore, a visiting consultant at the National University Hospital and Changi General Hospital (CGH), and an adjunct assistant professor at the Duke-NUS Graduate Medical School.
His wife is a dietitian specialising in critical-care nutrition at CGH. They have two daughters aged seven and eight.
I sub-specialise in bariatric surgery because...
Many people assume such surgery is about making people thin, but I view it as making people healthy.
Bariatric surgery refers to gastrointestinal procedures which reduce a person's food intake and modifies the way food is digested.
The resulting weight loss can dramatically improve obesity-related conditions such as diabetes mellitus, obstructive sleep apnoea, back and joint pain, as well as hypertension and cholesterol disorders.
The human body is fascinating because...
It is like a Ferrari. As long as you put in the right fuel (food), check the oil and tyres (biochemical markers such as blood sugar, blood pressure and cholesterol) and drive it regularly (exercise), no one can catch you.
If you do not take care of it and just leave it in the garage, you will have an expensive pile of junk.
One little known fact about losing weight is...
Everyone can succeed. People just need to learn the right approach for themselves and then keep their foot on the pedal.
Fewer than 10 per cent of the patients at the Life Centre, which treats lifestyle-related medical conditions, actually go for surgery.
If I were to give an analogy for what I do, I would be...
A chef in a cafe offering organic food. I transform people's relationship with food and life. My team and I provide wholesome, holistic and fun solutions. I believe in customising treatment to meet each individual's aptitude and preference.
A typical day for me...
Starts before 7am when my neighbour and I car pool to take our children to school. Then, he drops me off at Tanjong Pagar MRT station, where I take the train to Outram Park.
Every day is packed with work at clinics, endoscopy procedures or surgery, as well as meetings in the hospital.
I would be glad to knock off before 7pm to have dinner with my wife at home, although my children would have eaten by then.
I have come across all types of cases...
With 90 per cent of our patients having significant medical problems in addition to obesity. For instance, 50 per cent have diabetes or impaired glucose tolerance. Some have a history of stroke, heart attack and kidney disease.
I remember a kidney transplant recipient who had gained weight due to the steroids and immunosuppressant drugs she had to take.
The excess weight gave her diabetes and threatened the survival of her transplanted kidney.
We tried for more than a year to bring down her weight. Finally, after careful discussion, she underwent bariatric surgery.
She did so well that she eliminated all her diabetic medication, got pregnant and delivered a healthy baby.
Despite the many medical issues that our patients typically face, we have an excellent safety record for surgery. On average, our patients managed to cut down 70 per cent of their daily medication for conditions such as diabetes and hypertension within six months of bariatric surgery.
I love patients who are...
Well-read and motivated. These patients are usually clear about what they want to achieve and how much they are willing to sacrifice.
But we still have an important role to play as they often have difficulty achieving their goals on their own.
Patients who get my goat are...
Quite rare. I feel that people come to see me because they need help, so if my team and I cannot provide the support and guidance they need, we have failed them.
We dissect our failures religiously and define clear learning points to make improvements.
Things that put a smile on my face are...
When patients agree to participate in our research, which range from incentive-based weight loss to the effects of bariatric surgery on body composition and osteoporosis. Many people tell me Asians do not like to be "guinea pigs", but we are fortunate to see people who are ready to help not just themselves, but others too.
It breaks my heart when...
People know what they need to do to lose weight, but are unable to take control of their lives, allowing themselves to be adversely influenced by their own prejudices or others around them.
I would not trade places for the world because...
I am part of a specialised and dedicated team of health-care professionals providing integrated, patient-centric care.
Our treatment model is regionally unique, giving us interesting insights into managing obesity-related diabetes and metabolic disease.
Of course, it helps that I am the boss.
My best tip...
Is for people to eat real food. You would be surprised that people can eat many things today that are created in a laboratory from material that was originally inedible.
You may want to look up how some commercially prepared sausages, nuggets and margarine are made.
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