When doctors saw 14-year-old Mihir Jain who weighed 237kg, they were not confident about a successful weight reduction surgery.
Resident of Uttar Nagar in west Delhi, Mihir's staggering weight made him the world's heaviest teen to undergo gastric bypass surgery.
When his parents brought him to Max hospital Saket a few months ago for weight reduction surgery, he could barely stand. Why? Because a normal body mass index (BMI) - a person's weight-to-height ratio - is 22.5 kg/m2 and when it touches 32.5, a person is considered obese and may have to undergo surgery. A BMI above 40, 50 and 60 is categorised as morbid obesity, super obesity and super-super obesity, respectively. But, Mihir had a BMI of 92!
This made doctors sceptical of performing surgery on the teenager. "When I saw him first, I wasn't confident on operating him successfully. He was too heavy for that," Dr Pradeep Chowbey, a veteran bariatric surgeon who operated on Mihir, was quoted as saying Times of India.
But prior to the surgery, Dr Chowbey put Mihir on very low calorie diet (VLCD) consisting only about 800 calories a day because he wasn't confident of successful surgery. A normal diet contains 2,500 to 3,000 calories. Dr. Chowbey was not sure whether Mihir will come back to see him after four weeks of the rigid diet prescribed to him. "To my surprise, Mihir came to us again after four weeks. He had lost a good 10kg. I was happy to see their dedication and suggested to continue the same diet for another two months. His weight further reduced to 196kg. But post, this surgery was required and we put up his case for operation in April," Dr Chowbey said.
Mihir had a normal weight of 2.5kg when he was born in November 2003. But he gradually started gaining weight and by the time he was five, he weighed 60-70kg, his mother Puja Jain said.
Declaring his love for junk food, Mihir said, "I stayed mostly in the house lying down or sitting. Pasta is my favourite food. Pizza is second favourite."
His mother, Puja said, "Most members in our family are overweight so we didn't take it seriously then. But then a time came when he couldn't even walk properly due to heavy weight. He stopped going to school after Class II, and I had to teach him at home." The family had first sought medical help in 2010. But doctors at that said the boy was too young to undergo surgery.
The biggest challenge in operating on an extremely obese person is in administering anaesthesia due to presence of fat in the tongue, throat and neck. This restricts the space to put a tube into the lungs.
Dr Chowbey said they had to use special equipment - a flexible laryngoscope - to negotiate the difficult condition in Mihir's case. "Also, there is no guideline on the anaesthesia dosage for person weighing 200kg. Our doctors relied on their experience to decide on the right amount of anaesthesia," he said.
Besides, the doctors found it difficult to operate as there were 10-12 inches of fat beneath the muscles of Mihir's body. In a procedure lasting nearly two-and-a-half hours, doctors created a gastric bypass in which the digestive system is re-routed past most of the stomach which makes a person feel full on less food.
"Mihir was discharged within a week of the surgery. He comes to the hospital for follow-up though. Also, he has been asked to continue the restrictive diet," Dr Chowbey said. Mihir's mother said they've learnt a lesson from their crisis about the need to be physically active and avoid junk food.
This article has been adapted from its original source.
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