THE scalpel may hold the future for cure of deadly diseases like diabetes, hypertension, high cholesterol and sleep apnea. With bariatric surgery (also known as weight loss surgery) getting recognised as a standard procedure to treat obesity, medicos are now finding the surgery, or its variations, can hold the magic key to cure metabolic disorders as well. Not convinced? Research and clinical experience shows that bariatric surgery can cure obstructive sleep apnea by 90%, diabetes (Type 2) by 80-85%, reduce hypertension by 70%, can control high cholesterol levels and reduce arthritis. And a person sheds nearly 60% to 90% of their excess weight in a year's time of undergoing the procedure. Since the surgery is still largely practised for weight loss, there a strict selection criteria to undergo the process. People considered fit for the surgery need to have body mass index (BMI) of 32 and two or more complications or BMI of 37 without any complications. BMI is defined as the individual's body weight (in kg) divided by the square of their height (in metres). But non-obese people need not loose heart. "While bariatric surgery is still recommended for obese people, a new surgery is now evolving for the normal person,' says laparoscopic and obesity surgeon V. K. Bhartia. "Christened metabolic surgery, the procedure is currently in the experimental stage, but is showing promise to become a standard practise in a years time.' Advanced research in the realm of metabolic surgeries are now opening up immense possibilities. "People generally don't think of surgery as a treatment for diabetes or high blood pressure, but it is, and we expect metabolic surgery to play an ever increasing role in managing these disease,' says Apollo Gleneagles Hospital's bariatric surgeon B. Ramana. The American Society for Metabolic and Bariatric Surgery notes that bariatric surgery may improve insulin resistance and secretion by mechanisms independent of weight loss. This has created a new line of thought that such surgeries may be appropriate for type 2 diabetics who are of normal weight or only slightly overweight. But going for such procedures may pinch your pocket. While at present, bariatric surgery will cost at least Rs 2.5 lakh to Rs 3 lakh, medicos feel the treatment cost of metabolic surgery can be exorbitantly higher. However, here's a word of caution from Ramana: "Bariatric surgery or metabolic surgery are certainly not plastic surgeries and can have its share of complications. This can range from post-operative complications to severe infections. Hence, the risk factor needs to be weighed before advising such a surgery.' writankar.mukherjee@timesgroup.com