AIIMS doctors enable 209-kg man to walk, breathe freely after high-risk bariatric surgery
In a complex medical endeavour, doctors at the All India Institute of Medical Sciences (AIIMS), Delhi, have successfully performed bariatric surgery on a 32-year-old man who weighed 209 kilograms. The patient, who suffered from severe obesity-related complications, underwent a month-long preparatory programme before the procedure, which was initially considered to carry significant risk.
The man had a body mass index (BMI) of 74 kg/m², placing him in the category of 'super-super obesity'. His health had deteriorated due to severe obstructive sleep apnoea (OSA), respiratory failure, and other obesity-linked conditions including hypertension, prediabetes, and dyslipidaemia. His condition grew so serious that he required an emergency tracheostomy and remained dependent on continuous positive airway pressure (CPAP) support for more than a month prior to the operation.
His large body size created additional logistical hurdles. With an abdominal girth of 198 cm, he could not be safely positioned on a conventional operating table. To address these challenges, a multidisciplinary team of bariatric surgeons, anaesthesiologists, intensivists, physicians, infection-control specialists, dietitians, and physiotherapists collaborated to devise a pre-operative optimisation plan. The goal was to improve his respiratory function and reduce abdominal girth, making surgery feasible.
According to an official statement from AIIMS, the patient underwent a 32-day very low-calorie diet (VLCD), along with respiratory physiotherapy, infection control measures, and nutritional counselling. This rigorous regimen led to a reduction in his weight from 209 kg to 172 kg, and his abdominal girth decreased by 20 cm. This improvement allowed the medical team to safely position him on a modified operating table fitted with side extensions.
Following this preparatory phase, the surgical team performed a laparoscopic one anastomosis gastric bypass (OAGB). The procedure was completed in just over two hours without any major intraoperative complications. After surgery, the patient was gradually weaned off CPAP support. By the 13th post-operative day, he was able to breathe independently without assistance, walk without aid, and attend to his personal needs. Before discharge, his abdominal girth had further shrunk to 155 cm, and his weight had dropped to 160 kg.
The treating team emphasised that this case demonstrates how patients with extreme obesity, even those who require prolonged ventilatory support and have undergone tracheostomy, can be suitable candidates for bariatric surgery. The key, they noted, lies in careful pre-operative optimisation and coordinated multidisciplinary care. 'Reducing abdominal girth, rather than weight alone, proved critical in making the surgery feasible,' the institute stated.
Medical experts not involved in the case say this successful outcome offers hope for similar patients with severe obesity-related comorbidities. It also highlights the importance of individualized preparation and teamwork in managing clinically complex cases. The AIIMS team's approach may serve as a model for other tertiary care centres dealing with super-super obese patients.
The patient's recovery marks a significant milestone in his journey towards better health. He is expected to continue losing weight and improving his metabolic parameters under follow-up care. The case underscores the need for accessible, multi-speciality intervention for severe obesity, which is increasingly recognised as a chronic disease with far-reaching consequences.
