Bariatric surgery: There’s help for the obese

Bariatric surgery methods in the UAE offer hope for the extremely overweight

Image Credit: Clint Egbert/Gulf News
From left: Ajay Chaturvedi, Marketing Manager for International Modern Hospital; Shanon Salem Al Harthi; Mythily Anandhy; Allicia Michele; Dr. Girish Juneja, Director of Bariatric Center; Audrey Zhen Gonzales; Aaron Dann Gegajo and Mohamed Seoudi.
02 Gulf News

Dubai: The figures are alarming.

A large number (30 per cent) of school-going children in the UAE are obese and 70 per cent of women and 60 per cent of men are overweight.

These numbers were pointed out by a surgeon to highlight the growing dangers of obesity in the country.

“It not only affects your health but your lifespan too,” says Dr Girish Juneja, Head of Bariatric Surgery at International Modern Hospital, Dubai.

Being overweight or obese is a major risk factor for other complications such as heart disease, diabetes, hypertension (high blood pressure) and cancer.

Obesity or being overweight occurs over a period of time when you eat more calories than you can use. But the balance between calories in and calories out differs from person to person.

The factors that can tilt the balance are your genetic makeup, whether you eat high-fat foods, over-eat and whether you exercise or not.

You can use a measurement tool called the Body Mass Index (BMI) to know whether you are obese, overweight or under weight. BMI compares your height to your weight. It is done by dividing your weight by your height squared.

An example is:

82 kgs/ 1.83 m x 1.83 m = 24.5

A BMI of less than 18 means you are under weight

A BMI between 20 and 25 indicates you are at a healthy weight.

A BMI between 25 and 30 suggests you are overweight.

A BMI of 30 or more indicates obesity and you will have to consult a doctor to start losing weight.

There are many ways of reducing weight, the most traditional being exercise and lifestyle modifications but as time and history have proved, most people beg off this and prefer quick methods. Dieting has been a rage for centuries but its pitfalls are legion by now. Weightloss medicines too have taken a bad rap due to their side effects and scientifically unproven claims.

“To date, non-surgical treatments such as dieting or medications have not been very effective,” says Dr Juneja, who introduced a number of patients who had undergone bariatric surgery to reduce their weight. Bariartic surgery has been sought after in the recent years by many people suffering from obesity due to various causes. The surgery involves reducing the size of the stomach through various procedures so that you eat less amount of food.

But, having said that, bariatric (weight-loss) surgery is not for everyone. It is only recommended if you are BMI is 35 and you have co-morbidities such as diabetes and high BP. This type of surgery helps reduce weight and also resolves various conditions associated with over-weight such as joint pains and dyslipidemia, a condition in there are high amounts of lipids (cholesterol) in the blood.

“Many scientific studies have been done to show that bariatric surgery is more reliable and successful [than medical therapy]),” says Dr Juneja. “There is now a shift in the perception of bariatric surgery, which is not only recommended for weight loss but also for cure and improvement of associated diseases with obesity,” he says.

Basically, what bariatric surgery does it to change the anatomy of your disgestive system to limit the amount of food that you can eat and digest.

These surgeries are done by laparoscopy or key-hole surgery through 0.5cm-1cm holes in the abdomen.

A tiny video camera is inserted through the small incision allowing the surgeon to perform this minimally invasive type of surgery.

The laparoscope is a small tube that consists of a light source and a camera and relays the images inside on to a TV screen. Laparoscopies are also used to carry out surgical procedures and small devices, such as lasers, can be passed through the holes in the skin.

The advantages of laparoscopic surgery is that it is more precise and safe, leads to little post-operative pain and offers faster recovery than open surgery.

But this surgery is the last resort. The need of the moment is prevention rather than cure. The change, believes Dr Juneja, must begin in childhood. “We have to start with the children and teach them lifestyle changes so that they develop into healthy adults,” he says. He recalls a time recently when he had to perform a bariartic surgery on a 16-year-old. This, he believes, should not become the norm. Lifestyle modifications such as eating nutritious foods and leading an active life, need to be as mandatory to an individual’s health as brushing one’s teeth. Compromising one’s health is not an option.

“Diabetes is curable”

“The numbers of diabetes patients are on the increase,” says Dr Padma Kumar, specialist general surgeon in the diabetic and bariatric surgery team, International Modern Hospital, Dubai.

Asians, according to him, have a high incidence of diabetes due to their genetic make-up and this affliction is more deadly than cancer as it affects all organs of the body from the eye to the toe.

Such people are at risk of heart attack, stroke and kidney disease. Eye complications can lead to blindness and poor circulation can lead to amputation of the limb.

The surgical procedure offered is the Modified Sleeve Gastrectomy and Ileal Interposition. Through key-hole surgery, the stomach’s size is reduced so that the food intake is limited. The last length of the small intestine is brought towards the stomach that helps bring the partially digested food into the small intestine rapidly.

“This helps increase the GLP1 (a hormone) levels that increases insulin levels,” says Dr Kumar.

These two procedures are done together.

“Patients are amazed as the results are immediate,” he says. “The blood sugar levels drop even after eating food as the GLP1 helps produce good amount of insulin,” he says.

This surgery, offers long-term solution to diabetes. But not everyone can undergo this procedure; there are certain conditions such as the patient’s pancreas should be capable of producing good levels of insulin and that there should not be any anti-bodies, which can hamper production of insulin.

This type of surgery will require between 3 to 5 days stay in the hospital and a visit to the doctor every 3 months for check-ups.

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  • Clavin Fernandis

    Jun 13, 2013 12:06

    Dear readers, this is a magnificant way to lose weight. I did this in India in Jan 2012. I was 130Kg and after a year I am 75Kg. It is like a rebirth. I used to have lot of illness like hypertension, cholestrol, border line blood sugar and uric acid. I used to take at least 6 to 7 pills a day. After 4 months of surgery, i stopped all the pills.Of course your eating becomes minimal, but that is worth it. Again I had a major wardrobe malfunction, again worth it. I urge all my freinds who are obese, live to eat do not eat to live. Go ahead for this surgery and you will have a new life.

  • Donald Glass

    Jun 13, 2013 9:38

    It would be nice to hear from the insurance companies that these types of surgeries can be covered by medical insurance when comorbidities like diabetes exist in patients. For patients like these, it is not cosmetic surgery, it is a matter of life or death. The doctor says"diabetes is curable" with these surgeries. How can the cure for a deadly disease cost a patient with insurance Dh40-50,000? It would be nice to see HAAD and the Dubai Health Authority recognised this and insist that insurance companies cover these surgeries when recommended by a doctor.

Latest Comment

Dear readers, this is a magnificant way to lose weight. I did this in India in Jan 2012. I was 130Kg and after a year I am 75Kg. It is like a rebirth. I used to have lot of illness like hypertension, cholestrol, border line blood sugar and uric acid. I used to take at least 6 to 7 pills a day. After 4 months of surgery, i stopped all the pills.Of course your eating becomes minimal, but that is worth it. Again I had a major wardrobe malfunction, again worth it. I urge all my freinds who are obese, live to eat do not eat to live. Go ahead for this surgery and you will have a new life.

Clavin Fernandis

13 June 2013 12:51jump to comments