A multi-disciplinary team at Burjeel Medical City offers end-to-end weight management solutions

BMC has a centre for weight loss and bariatric surgery that provides a comprehensive pathway for obesity management, comprising experts in the fields of nutrition, weight management medicine, and bariatric and metabolic surgery. The initial assessment offers detailed consultations to develop a patient-centered plan for non-surgical (medical pharmacotherapy) and surgical weight-loss solutions or both. In general, medications are approved for patients with a BMI of 30 or higher, or a BMI of 27 or higher with at least one obesity-related comorbidity like high blood pressure, diabetes, or high cholesterol. For patients with a BMI above 35 (with medical comorbidities), and for whom losing weight needs a long-term and sustained path, weight-loss surgery can produce significant results. “From the early stages of obesity, where endoscopic procedures may be offered, to the more invasive surgical operations covering the whole spectrum of indications for both primary and revision cases, we are equipped to provide patients with the highest standard of care,” said Dr. Raad Usama Al Mehdi, Consultant and Head of Bariatric and Metabolic Surgery.

“A holistic assessment is conducted to identify the possible causes and metabolic diseases. At BMC, patients receive a personalized plan based on their preferences, comorbid conditions, and lifestyle. Behavioral changes, dietary plans, and physical activity are emphasized in the treatment plan,” said Dr. Mohammad Fityan, Designated Institutional Official, Consultant Internal Medicine and HOD Weight Management Clinic.

Increasing risk of non-communicable diseases

Excess weight can have a wide range of serious medical consequences and is a major contributor to the development and worsening of type 2 diabetes and diabetes-related complications. According to the endocrinology experts at the hospital, excess weight is associated with an increased risk of all-cause and cardiovascular mortality. It is linked to increased and progressive risk of a broad range of cardiometabolic diseases such as cardiac events, cardiac failure, and stroke. “The goal of obesity therapy is to prevent, treat, and reverse all cardiometabolic complications and improve the quality of life of people with excess weight,” said Dr. Abu Baker Mohamed Elamin Ahmed, Consultant Endocrinology.

Obesity increases the risk of the major CKD risk factors – type 2 diabetes and high blood pressure. People who are overweight or obese also have a higher chance of developing End Stage Kidney Disease (ESKD) and acute kidney injury (AKI). BMC offers patient-centered care to those suffering from kidney disease. Its leading nephrology division provides advanced services through the dialysis unit and renal transplant center. “Obese patients fall at high risk for the prevalence of kidney diseases. It is recommended to have periodic screening for kidney diseases through blood and urine tests and in selective cases, by doing relevant imaging tests. At BMC, the Nephrology service can help you safeguard your kidneys by working closely with the multidisciplinary team to address obesity-related complications,” said Dr. Venkat Sainaresh Vellanki, Director of Transplant Nephrology.

People who are overweight are three times more likely to develop acid reflux and GERD. Frequent heartburn, regurgitation of food, and difficulty swallowing are some of the symptoms of GERD. BMC has a dedicated Acid Reflux Clinic that offers conservative acid reflux treatment options and minimally invasive surgical interventions to treat GERD. Laparoscopic Nissen Fundoplication and Toupet Fundoplication, and Laparoscopic Roux-en-Y Gastric Bypass are some of the procedures offered at the hospital. “The most common surgical treatment we offer is the laparoscopic anti-reflux surgery that eliminates acid reflux by establishing a new valve mechanism at the base of your esophagus,” said Dr. Ali Iyoob Valiyaveettil, Consultant and Head, Gastrointestinal Surgery.

Extra weight is also a major contributing factor to orthopedic problems. A team of world-class orthopedic surgeons at BMC, treat the full range of orthopedic problems in obese patients. Total Knee Arthroplasty and Total Hip Arthroplasty are some of the solutions offered to these patients at the hospital. “Through leading-edge treatments, we focus on improving the quality of life of obese and overweight patients who experience orthopedic problems. We have an expert team that offers comprehensive treatment for the surgical management of knee pain and other orthopedic problems,” said Dr. Rashed Al Shaeel, Consultant & Head of Orthopedics & Trauma.

Obesity can cause urological issues in both men and women. Carrying extra fat in the midsection of the body can alter the normal structure and function of the pelvic organs. In male patients, there can be loss of libido, testicular pain, and fungal infections. In women, there may be recurrent vaginitis and inflammatory disorders of the private parts. “Most of these conditions reverse when obesity is treated effectively. Don’t hesitate to seek treatment for obesity as it is the root cause of many problems. We are here to help,” said Dr. Rishikesh Ramesh Pandya, Consultant Urology.

The hospital’s psychiatrists offer their expertise in assessing patients for bariatric surgery and help patients with behavioral and other tools needed to achieve long-term weight loss. “The psychiatry department collaborates with the bariatrics team to not only evaluate a patient before surgery but also to follow-up after the procedure and if in case of any psychological issues, offer intervention,” said Dr. Reem Elbakri, Consultant Psychiatry.

Tackling childhood obesity

Child obesity is a global problem that affects about 340 million adolescents and 39 million children. Childhood obesity is designated as a chronic disease; the causes for which are multifactorial, including genetics, socio-economical and environment. Unless actively addressed, childhood obesity can lead to long-term physical and mental health issues. BMC has a holistic approach to the treatment of obesity.

“At BMC, we offer a multi-disciplinary and child-centered approach to managing childhood obesity. It must be tackled aggressively as obese children are at risk for many health issues, including diabetes mellitus, kidney disease and nonalcoholic fatty liver disease. They also tend to have an increased tendency for depression, low self-esteem, and stress,” said Dr. Krish Venkatesh, Consultant Pediatric Gastroenterology.

Treating cardiovascular disease

BMC’s cardiologists and vascular surgeons are experts at diagnosing and treating heart disease and vascular conditions in obese and overweight patients. According to these experts, Peripheral arterial disease (PAD) is a chronic disease in which plaque

gradually builds up in the arteries of the legs. According to Dr. Prathap Chowdary Potula, Consultant Vascular Surgery, those with symptoms often complain of muscle cramping while walking or pain in the toes and feet while resting. Apart from PAD, obese patients have an increased risk of developing blood clots in leg veins known as Deep Vein Thrombosis. Additionally, varicose veins may become more prominent after bariatric surgery and weight loss.

“The Vascular Surgery Department at BMC offers minimally invasive techniques including catheter-based techniques to treat PAD, deep venous thrombosis and varicose veins when symptomatic,” said Dr.Yasir Suliman, Consultant Vascular and Endovascular Surgery.

Life after weight-loss

Patients who have undergone drastic weight loss after bariatric surgery are often conscious of the loose skin on their bodies. For such patients, who are close to their weight goal and have been able to maintain a stable weight, the plastic and reconstructive surgery department at the hospital provides a range of treatments including, Liposuction, Apronectomy/Panniculectomy, Abdominoplasty, Circumferential lipectomy/ Belt lipectomy, Mastopexy with/without augmentation (silicone implant/ fat grafting), Reduction Mammoplasty, Male breast/ Gynecomastia correction (VASER, mastectomy), Back lift, Brachioplasty, Liposuction, Thigh lift, Facelift, Browlift, and Neck liposuction.

“We offer solutions for hanging/loose skin and other concerns that patients have after major weight loss. We will help you determine the right time and guide you to choose the best plastic surgery procedure, tailor-made to your requirements after your weight-loss journey,” said Dr. Leon Alexander, Consultant Plastic Surgery.