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Dr. Ramen Goel - Bariatrician, Mumbai

Dr. Ramen Goel

88 (50 ratings)
MBBS, MS - General Surgery

Bariatrician, Mumbai

33 Years Experience  ·  1500 at clinic  ·  ₹300 online
Book appointment and get ₹125 LybrateCash (Lybrate Wallet) after your visit
Dr. Ramen Goel 88% (50 ratings) MBBS, MS - General Surgery Bariatrician, Mumbai
33 Years Experience  ·  1500 at clinic  ·  ₹300 online
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Hi.<br/><br/>I am Dr. Ramen Goel and today we are going to talk about safe outcomes of bariatric ...

Hi.

I am Dr. Ramen Goel and today we are going to talk about safe outcomes of bariatric surgery. So it has been seen that the surgery can be safely done if the surgeon is doing large volumes of surgery every year. So, general cut off is about 100 surgeries a year. So those who do more than hundred surgeries, the outcomes are better. Outcomes also depend on what is the kind of follow up the program is providing; do they have a counselor; do they have a dietician and outcome also depends on patient's condition before surgery.

So, if they have controlled diabetes, controlled blood pressure, thyroids are well-taken care; the outcomes are better. Outcomes are also better if the patient is compliant that means you follow the instructions that are given by the bariatric program. So bariatric surgery overall can be achieved with very very fewer complications. Complications almost at par with hernia surgery provided you choose the right surgeon and you are willing to follow the instructions. If you need any more details you can connect me through Lybrate.

Thanks!

read more
Hi,<br/><br/>I am Dr. Ramen Goel. Today we will talk about whether surgery should be offered to a...

Hi,

I am Dr. Ramen Goel. Today we will talk about whether surgery should be offered to all uncontrolled diabetic patients? Now in last 10 years it has been accepted worldwide that metabolic surgery is a good option for diabetes control and gradually the cut off point has been reduced to 27.5 BMI. That is if someone is about 10 to 12 K.G. overweight he can get the surgery done to control his diabetes.

It is also been seen that this surgery work better if you do it early. If somebody has diabetes for last 6 months he will do a very well after surgery compared to those who have diabetes for last 20 years. So gradual realisation has come that surgery should be offered early and many physicians are actually sending patients who are actually prediabetic because their pancreatic function is quite good and after surgery if the pancreatic function is good the outcomes are better.

So for all uncontrollable diabetic, metabolic surgery is a good option. Don't considered as a last option. Don't wait till the pancreas are damaged irreversibly. It should be done at a stage and then it can give you disease free, drug free life for very long time and that's very important.

If you need any further information about this, please connect with me on Lybrate.

read more
Hi,<br/><br/>I am Dr. Ramen Goel.Today I am going to share with you the current information that ...

Hi,

I am Dr. Ramen Goel.Today I am going to share with you the current information that it is the physiological changes that happens after bariatric surgery which are responsible for weight loss. Typically we believed that after surgery because the stomach is small, there is restriction on food intake and weight loss happens. But research in last 5-10 years have established that it is not the restriction of the food intake but it is the physiological changes which includes changes in Ghrelin hormone, changes in GLP-1 hormone, changes in the bacterial which are present in the gut, changes in the bile acid levels in the blood. All these together are responsible for physiological changes and that helps in weight loss.

Now look at the scenarios, if someone gets pregnant in 2 months after surgery, then the person will gain weight, they will not lose weight. So if only the stomach size was responsible for weight loss this lady cannot gain weight. So the physiology of pregnancy is much stronger than the surgery and that's why the current concept says that just by restricting the food intake you cannot lose weight. It is a physiology, biology which changes the body. Its a great information because at no stage with diet manipulation you can lose as much weight as with surgery because the physiological changes do not happen after dietary regulation.

If you need any further information about it, please connect with me through Lybrate.

read more
Hi,<br/><br/>I am Dr. Ramen Goel.  Today we are going to talk about that Bariatric surgery is not...

Hi,

I am Dr. Ramen Goel.  Today we are going to talk about that Bariatric surgery is not the last option for morbidly obese patients. It's probably the only option for these patients. Why I say this, because when a morbidly obese person goes to do lifestyle changes they can always lose weight, but there is a 98% probability that within 3 years they will regain all the weight and everytime they lose weight and their gain weight, they lose more muscle and they gain more fat.

So they become physically weak. I think surgery is a very good option for them at early stage. Logically people do think that you should try everything and then you should consider surgery but scientifically looking at it, anybody who is more than 32.5 BMI and has diseases or 37.5 BMI and even if they don't have a disease they are a good candidate for surgery.

If you need any more detail you can connect with me on Lybrate.

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Hello and thank you for visiting my Lybrate profile! I want to let you know that here at my office my staff and I will do our best to make you comfortable. I strongly believe in ethics; a......more
Hello and thank you for visiting my Lybrate profile! I want to let you know that here at my office my staff and I will do our best to make you comfortable. I strongly believe in ethics; as a health provider being ethical is not just a remembered value, but a strongly observed one.
More about Dr. Ramen Goel
Dr. Ramen Goel is a popular Bariatrician in Mumbai Central, Mumbai. He has helped numerous patients in his 30 years of experience as a Bariatrician. He has completed MS - General Surgery, MBBS. You can consult Dr. Ramen Goel at Wockhardt Hospitals Ltd - in Anu Shakti Nagar, Mumbai. Book an appointment online with Dr. Ramen Goel on Lybrate.com.

Lybrate.com has a number of highly qualified Bariatricians in India. You will find Bariatricians with more than 28 years of experience on Lybrate.com. You can find Bariatricians online in Mumbai and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Specialty
Education
MBBS - Aligarh Muslim University - 1986
MS - General Surgery - Aligarh Muslim University - 1989
Languages spoken
English
Hindi
Professional Memberships
All India Association Of Advancing Research In Obesity (AIAARO)
Association of Surgeons of India

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Center of Metabolic Surgery, Wockhardt Hospitals Ltd -

Unit - Adams Wylie Memorial, 1877, Dr Anand Rao Nair Marg, Mumbai CentralMumbai Get Directions
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1500 at clinic
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Dr. Ramen Goel Feeds

Bariatric Surgery - Lifestyle Changes You Must Follow!

Bariatric Surgery - Lifestyle Changes You Must Follow!

Bariatric surgery refers to the procedure by which weight loss happens gradually within 12-18 months after modification in size of stomach and/or intestines modification through key hole surgery.

The diet that must succeed a bariatric surgery changes with time. A post bariatric surgery diet will tentatively look like:

  1. Initial stages: At the initial stage, eating solid food should be strictly avoided. A liquid diet with added protein is recommended to avoid strain on staple/suture line.
  2. Intermediary stages: The diet must be changed post second till the sixth week as soft diet is permitted. Due to the surgery, it is only normal that you would feel full after small consumption thereby, necessitating intake of food at regular intervals.
  3. Final stages: Post sixth week, incorporating solid food in the diet is generally allowed by the doctors. However adequate protein intake remains a necessity.

Besides dietary modifications, patients are recommended to gradually start exercising to protect muscle mass and also to help maintain weight in long term. Usually strength training exercises are recommended besides moderate aerobic workout.

Is There A Relation Between Weight Loss Surgery & Type 2 Diabetes?

Is There A Relation Between Weight Loss Surgery & Type 2 Diabetes?

Is there a relation between weight loss surgery and type 2 diabetes? Yes, there is and a very promising one. Many diabetics may not know this but a key hole procedure called metabolic/ bariatric surgery can help resolve type 2 diabetes.

It’s scientifically proven that these surgeries can normalize blood sugar levels and control diabetes in most patients. This means that you may not need any medicines post such a surgery. One long-term study which tracked 400 people with type 2 diabetes showed that six years after bariatric surgery, 62% diabetics showed normal blood sugar levels. Apart from this, they also showed better blood pressure, cholesterol and blood triglyceride levels that can cause heart disease.

Should you get a metabolic/bariatric surgery done? You are a fit candidate for bariatric surgery if your:

  1. BMI is 27.5 or higher
  2. And if are finding it difficult to maintain blood sugar with medicines & lifestyle changes.

Your doctor will give you a physical exam to check whether you are fit for a major surgery and if you are emotionally ready to commit to necessary lifestyle changes like eating healthy and exercising regularly.

Types of weight loss/diabetes surgery:

The most popular type of weight loss surgery is one in which the size of your stomach is reduced so that you feel full even after small meals. Other types of bariatric surgeries change the way your body absorbs calories and nutrients and vitamins. A few other types of bariatric surgeries do both.

  1. Gastric Bypass: In this surgery, your surgeon makes a small stomach pouch by dividing the top of the stomach from the rest. This small pouch is connected to intestine so other part of stomach is bypassed. So, when you eat, food goes into this small pouch, which makes you feel full faster and also makes it possible for your body to absorb fewer calories. This is a very promising type of bariatric surgery for diabetics as up to 80% of people have normal blood sugar after it. And they also lose 60% to 80% of their extra weight on an average.
  2. Gastric Sleeve: In this surgery, your surgeon will remove a major part of your stomach. When your stomach is small, you will feel full faster. It also reduces hunger pangs. This type of surgery is also very effective in reducing diabetes and losing weight.
  3. Adjustable Gastric Band: In this surgery, your surgeon puts an inflatable band around the top of your stomach. This forms a small pouch which makes you feel full faster. The good point is that your stomach is not cut and your intestines are not shifted. There are thus lesser complications. It also helps in controlling diabetes. The con is that you lose less weight in this type of surgery.
  4. Biliopancreatic DiversionThis is an uncommon surgery but most effective for diabetics. In this the doctor removes a large part of your stomach and also changes the way the food goes to your intestines. This helps in losing weight but also affects digestion long term.

As with any major operation, all bariatric surgeries come with potential risks of bleeding, infection, and leaks in the digestive system. It is necessary to change lifestyle to avoid weight regain.

3238 people found this helpful

Bariatric Surgery - What Are The Benefits Of It?

Bariatric Surgery - What Are The Benefits Of It?

Most individuals prefer to be in the best of shape and look flawless by getting rid of those extra inches or fat in the body. Excess fat, not only affects the self-confidence of the person, but also gives rise to several health problems. Bariatric surgery is recommended as a treatment option, for such problems & obesity itself.

Popularly known as the weight loss surgery, bariatric surgery is a popular treatment that has shown results and helped people to get into shape. To describe the process in simpler terms, it is a surgical procedure on the stomach and the intestines that result in substantially reduced food intake and weight loss in an individual. Bariatric surgeries can be of different types but it is important to remember that they are not cosmetic surgery.

Other Benefits of Bariatric surgery besides weight loss:

  1. Bariatric surgery reduces the risk of cancer(s).
  2. Obesity has proved to affect the psychological functioning of a person - surgery helps one to regain their self-esteem and improves quality of life.
  3. Obesity causes menstrual irregularities and fertility problems in women. Bariatric surgery helps to improve fertility and reduces the chances of complications during pregnancy.
  4. The surgery helps one to live a longer life by reducing possibility of early sudden death usually associated with obesity.
  5. Surgery has also proven to help with health conditions such as arthritis, high blood pressure, sleep apnea, high cholesterol, type 2 diabetes, soft tissue infection and venous stasis disease.

Bariatric Surgery at present is one of the most common weight reducing surgeries but before considering it, it is important to gather as much knowledge as possible about the process and to also get it done under the supervision of a well trained and experienced doctor.

Though patient and family spends considerable time trying to understand the pros & cons of surgery, the single most important differentiator in outcome of bariatric surgery is post-operative care/support system affiliated with the surgeon.

The long-term risk of remaining obese is much greater than undergoing bariatric surgery. Though bariatric surgery in established clinics is performed by certified doctors only, still it is very important to research the surgical and back up facilities of the hospital. With internet support, one can also assess a program’s outcomes and safety track records. There is no harm in asking a straight or blunt question regarding number of surgeries done and even number of complications in the surgeon’s hands. It may appear difficult to decide but research and frank discussion can help make right choices

1 person found this helpful

Obesity - Know Harms And Causes Of It!

Obesity - Know Harms And Causes Of It!

Obesity is a serious problem wherein a person gains excessive weight, thus restricting his or her movement, ultimately leading to various kinds of health problems. 

How to know if I am obese?

Obesity is basically a condition where there is an excess proportion of the total body fat. Generally, a person is considered obese by looking at two factors:

  1. Body Mass Index - In a Caucasian, BMI of 30 or more indicates obesity while in an Indian, BMI of 25 qualifies him as obese.
  2. Circumference of the waist - If a person’s shape is that of an apple or has a potbelly, then that person carries more fat about the abdomen. This tends to increase the risk of developing the problem of obesity.

Can obesity or being overweight cause medical problems?

Yes, if you are overweight or obese, it can lead to a range of health problems, which include:

  1. High blood pressure
  2. Heart disease
  3. Stroke
  4. Diabetes
  5. Osteoarthritis
  6. Gout

In case a person is 40% overweight, he or she is 2 times more likely to die a premature death.

What are the risk factors to be considered with regard to obesity?

The risk factors which one must not ignore if one has the tendency of becoming overweight are:

  1. Pre-existing medical conditions – High blood pressure, high level of cholesterol or high sugar level are major warning signs of diseases associated with obesity.
  2. The family history of suffering from chronic diseases – If a person’s parents or close relatives are suffering from heart disease or diabetes, then there is every chance for the person as well falling prey to these problems.

What leads to obesity?

 There are certain factors which play crucial role towards making a person obese:

  1. Environmental Factors - If a person is less active and mainly spends time sitting in a place, without any kind of physical activity, a person is bound to gain weight. Consumption of fatty, oily foods and sweets worsen the condition.
  2. Psychological Factors - Around 30% of people, who seek treatment for serious problems regarding weight have problems with binge eating. Binge eating involves, having a large amount of food with the feeling as if they are unable to control themselves. There are people who eat a lot in response to negative emotions like boredom, anger or sadness.
  3. Genetic Factors - Obesity is a problem that usually runs in families. Family members not only share genes but also their diet and lifestyle habits.

How can you treat this problem of obesity?

The treatment of obesity through losing excess weight is a long-term proposition. It does not happen overnight. Weight loss must be gradual as attempts to drastically lose weight might backfire and cause other health problems. Bariatric surgery is one of the best ways other than maintaining a healthy diet and lifestyle with physical activity to control obesity. Consult your doctor today. 

2 people found this helpful

I want to manage my weight as it is causing knee problem for the past 6 months. I am asthmatic and also suffer from hypothyroidism for the past 20 years. I take 75 mcg of thyronorm tablet daily. For asthma, I am not on any regular medication. I take inhaler sos.

I want to manage my weight as it is causing knee problem for the past 6 months. I am asthmatic and also suffer from h...
Dear lybrate-user, you are apparently a good candidate for bariatric surgery. This can help you lose over 30 kgs, which is likely to provide relief in your knee pain and reduce frequency of asthmatic attacks.

Safe Outcome Of Bariatric Surgery

Play video

Hi.

I am Dr. Ramen Goel and today we are going to talk about safe outcomes of bariatric surgery. So it has been seen that the surgery can be safely done if the surgeon is doing large volumes of surgery every year. So, general cut off is about 100 surgeries a year. So those who do more than hundred surgeries, the outcomes are better. Outcomes also depend on what is the kind of follow up the program is providing; do they have a counselor; do they have a dietician and outcome also depends on patient's condition before surgery.

So, if they have controlled diabetes, controlled blood pressure, thyroids are well-taken care; the outcomes are better. Outcomes are also better if the patient is compliant that means you follow the instructions that are given by the bariatric program. So bariatric surgery overall can be achieved with very very fewer complications. Complications almost at par with hernia surgery provided you choose the right surgeon and you are willing to follow the instructions. If you need any more details you can connect me through Lybrate.

Thanks!

3193 people found this helpful

Bariatric Surgery - Know Regimen After It!

Bariatric Surgery - Know Regimen After It!

Bariatric surgery refers to the procedure by which excessive weight is gradually reduced over months after modification in size of stomach through a keyhole surgery.

The diet that must succeed a bariatric surgery changes with time. A post bariatric surgery diet will tentatively look like:

  1. Initial stages: A liquid diet with added protein is suggested for 2 weeks to allow stomach tissue to heal. The bariatric dietitian usually advises portion control eating to avoid stretch on staple line and vomiting.
  2. Intermediary stages: The diet must be changed post second till the sixth week as the meal is made thicker. Due to the surgery, it is only normal that you would feel full after small meal.
  3. Final stages: Post sixth week, incorporating solid food in the diet is generally allowed. With the introduction of solid food, it is advisable to primarily focus on protein intake to reduce number of meals per day.  

Along with diet modification, you may also practice certain exercises to expedite weight loss and to avoid muscle loss usually associated with weight loss. Usually strength training exercises are preferred after surgery to improve muscle mass and to increase sustained calorie consumption.

3308 people found this helpful

Bariatric Surgery - Can It Subdue Danger Of Cancer?

Bariatric Surgery - Can It Subdue Danger Of Cancer?

Obesity can make life miserable. From unhealthy eating habits to unhealthy lifestyles and medical conditions, obesity can be an amalgamation of many factors. Obese people are at a greater risk of suffering from many serious health complications like type-2 diabetes, mood swings, and depression, cardiac problems, high blood pressure and high cholesterol, to name a few. It does not stop there. More alarming is the fact that obese people are at an increased risk of suffering from different types of cancer.

Bariatric surgery comes as a saviour for highly obese people (with a BMI over 40), who have tried every possible treatment under the sun to lose weight without any success. Bariatric surgery has helped many severely obese people attain a healthy weight. Bariatric surgery can be of three types;

  1. Gastric bypass surgery (Roux-en-Y): This is a common types of weight-loss surgery practiced worldwide for over 50 years. The procedure involves dividing the stomach into a smaller upper pouch and a larger lower part. The smaller pouch is then connected to the small intestine. The food consumed will pass into the small intestine through the pouch. The idea is to rearrange the stomach in such a way that a person consumes lesser quantity of food.
  2. Sleeve Gastrectomy: In Sleeve Gastrectomy, surgeons remove a large portion of the stomach, leaving behind only a small sleeve-like pouch (hence the name). Like the other surgeries, sleeve gastrectomy also aids in limiting the consumption of food.
  3. Duodenal switch: Duodenal switch with bilio-pancreatic diversion, is not very commonly used esp in Indian patients due to dietary preferences.  

Bariatric surgery has several health benefits. In addition to the weight loss, it plays a pivotal role in lowering the incidences of type-2 Diabetes, depression, anxiety, coronary artery problems, sleep apnea,  poly cystic ovarian disease etc.

Research also suggest that bariatric surgery is instrumental in reducing the chances of cancer (especially colon and breast cancer) by as much as 60%. Some researchers and oncologists believe that the weight loss (bariatric surgery) brings about a hormonal modification which prevents the growth of tumour cells. Another study links obesity with increased inflammation, which is believed to act as a catalyst accelerating the growth of cancer cells. However, research is still going on to understand this correlation (obesity and reduced cancer rates) better.

3399 people found this helpful

Bariatric Surgery - Know Forms Of It!

Bariatric Surgery - Know Forms Of It!

Bariatric surgery is a procedure that involves modifications to the digestive system to restrict calorie intake or nutrient absorption by the body. These surgeries are usually recommended when lifestyle changes like exercise and diet may not cause the desired weight loss. In most such patients bariatric surgery can help lose 60% -100% excess weight within 1 year.

The various types of surgeries that come under this category are -

1. Gastric bypass – A common bariatric surgery, gastric bypass works through alteration of stomach size and re-routing of small intestine in a way that it leads to reduced consumption of calories. This procedure also causes alterations in the behavior of the gut hormones resulting in appetite reduction.

2. Sleeve gastrectomy – Commonest bariatric surgery, in this procedure almost 80% of the stomach area is removed surgically, which cause an overall reduction in the amount of calories consumed. This results in modification of gut hormones and altered gut bacteria linked with reduced appetite.

4. Biliopancreatic Diversion with Duodenal Switch - This procedure involves surgical removal of a large area of the stomach along with bypassing a major portion of the smaller intestine. This procedure may reduce fat absorption of up to 70%. The behavior of the gut hormones change resulting in a decrease in appetite and improved satiety.

3094 people found this helpful

Changes After Bariatric Surgery

Play video

Hi,

I am Dr. Ramen Goel.Today I am going to share with you the current information that it is the physiological changes that happens after bariatric surgery which are responsible for weight loss. Typically we believed that after surgery because the stomach is small, there is restriction on food intake and weight loss happens. But research in last 5-10 years have established that it is not the restriction of the food intake but it is the physiological changes which includes changes in Ghrelin hormone, changes in GLP-1 hormone, changes in the bacterial which are present in the gut, changes in the bile acid levels in the blood. All these together are responsible for physiological changes and that helps in weight loss.

Now look at the scenarios, if someone gets pregnant in 2 months after surgery, then the person will gain weight, they will not lose weight. So if only the stomach size was responsible for weight loss this lady cannot gain weight. So the physiology of pregnancy is much stronger than the surgery and that's why the current concept says that just by restricting the food intake you cannot lose weight. It is a physiology, biology which changes the body. Its a great information because at no stage with diet manipulation you can lose as much weight as with surgery because the physiological changes do not happen after dietary regulation.

If you need any further information about it, please connect with me through Lybrate.

2601 people found this helpful