Abu Dhabi: With obesity a major issue in the UAE, bariatric surgeries have become a preferred mode of treatment for many patients who have long been struggling with their weight. The guidelines that allow patients to opt for bariatric surgery may soon be revised, and these changes could make weight-loss surgery more accessible for those in need, top surgeons have said.
“According to established guidelines in the UAE, patients with a body mass index less than 50 need to undergo up to six months of lifestyle modifications and pharmacotherapy before they are allowed to proceed with the surgery.
“Most patients approach us when they have actually tried both lifestyle modifications and medication therapy, and the revised guidelines may therefore be a step in the right direction,” he said.
“People are now more aware of these risks, and that has prompted the increase we have seen in the number of bariatric surgeries in the country,” Dr Ata said.
In the capital, the Shaikh Khalifa Medical City, a public health care facility, was one of the first centres to start offering bariatric procedures in 2009. By November 2015, it had performed 1,000 surgeries.
Meanwhile, Healthpoint, a hospital under the Abu Dhabi Government-owned Mubadala Healthcare network, has seen a 66 per cent increase in the number of weight-loss procedures between 2016 and 2017.
A total of 374 bariatric surgeries were performed in 2017, amounting to 31 every month on average.
While bariatric surgery is known to be effective, surgeons cautioned that weight loss is only achieved when patients also undertake comprehensive lifestyle changes.
Why psychological assessment
Some individuals eat for comfort and stress relief: “Being able to eat less after the surgery due to reduced stomach capacity may actually lead to depression. This is why it is mandated that patients undergo psychological assessment before the procedure, and are rigorously followed up if they are cleared for the surgery,” Dr Ata explained.
Some people have a sweet tooth syndrome: “A person who indulges in sweets throughout the day would not benefit from a procedure that only reduces the volume of their stomach because they gain their calories from small portions of calorie-rich foods,” Dr Ata said.
The chance of weight loss after surgery is naturally lower among the elderly because they have a lower metabolic rate, face higher surgical risk and have more ingrained negative eating habits.
“Weight loss is also harder for wheelchair-bound and mentally challenged patients, so we are less likely to advise surgical weight management for them,” Dr Al Hadad said.
Patients must follow through
“Patients must ensure they use surgery to lose excess weight, and maintain their weight loss,” Dr Ata said.
In general, female patients, as well as younger people, tend to be more compliant with weight-loss advice. “Women also take better care of themselves, and their anatomy makes it easier to perform bariatric surgeries because they have less visceral fat,” Dr Al Hadad added.
Who is eligible for bariatric surgery?
Patients must meet a number of criteria for bariatric surgery to be a recommended form of treatment.
One of the first criteria that is considered is the body mass index or BMI, which is calculated as a ratio of height to body mass. So, surgery is recommended when:
A patient has a BMI above 30 with three comorbidities such as hypertension, diabetes, hypercholesteraemia, joint pain, chronic backache or sleep apnoea.
A patient has a BMI between 35 and 40 with three comorbidities.
A patient has a BMI of 40 without any comorbidities.