Health & Fitness
I’m fat, should I do surgery?
Friday, May 3, 2019 14:31
By DR MUKUHI NG’ANG’A
Q: I am a 42-year-old man and I need a permanent weight loss solution. I weigh 152 kgs and since I am 5 foot 9 inches, my doctor told me that I am morbidly obese. I have always been big (even as a child) and I have never had any problems with it.
Recently, I was diagnosed with high blood pressure and was informed that I am developing diabetes. My knees and back also constantly pain. I try to eat healthy but I have not seen any results of the above.
I regularly go to the gym but I do not seem to be losing any weight. I think surgery might be the only option for me but I have a few questions regarding this.
What exactly is done during the surgical procedures? Is weight loss guaranteed after the procedures? Do these procedures fail? Are there local specialists in weight loss surgery? Does health insurance cover these procedures?
Weight loss surgery, medically known as bariatric surgery, has increased in popularity. The surgery changes the anatomy of the digestive system, allowing the body to take in less food.
However, not everyone is a candidate for surgery. Even for those who might be possible candidates, rigorous lifestyle and mental assessment must be done before clearing someone for surgery.
Who gets weight loss surgery
—People with a body mass index (BMI) is 40 or higher (extreme obesity).
—People with a BMI is 35 to 39.9, and have a serious weight-related health problem, such as type 2 diabetes, high blood pressure, heart disease, stroke, severe reflux or severe sleep apnoea.
The BMI assesses weight and see if it appropriate for one’s height. The ideal BMI is 18.5 to 25.
Because your current BMI is 50 and you have multiple obesity related complications, this qualifies you for weight loss surgery.
In addition, you must first prove that you are dedicated to changing your lifestyle. Usually, doctors will require you to have changed your diet and be on a regular exercise plan for at least three to six months before surgery.
Unhealthy drinking habits and smoking must also be stopped.
Emotional eating: There are people who eat to cope with stress and other challenges. Usually, these people tend to be compulsive in their eating and may continue to eat unhealthily even after surgery.
Emotional eaters require counselling on how to deal with their stressors (and avoid the urge to compulsively eat when unhappy).
Types of weight loss surgeries
Restrictive surgeries: This work by shrinking the size of the stomach and slowing down digestion. The stomach normally holds three to four pints of food. After surgery, the stomach capacity is reduced to less than 300mls.
The reduction in the amount of food you eat ultimately leads to weight loss.
Malabsorptive surgeries: This procedure alters the connections in the intestines and makes it difficult for the body to absorb nutrients.
Most surgeons combine malabsorptive procedures with some type of restrictive surgery. This is to reduce side effects of malabsorption.
Implanting an electrical device: This is a relatively new procedure. It involves implanting a device that interferes with nerve signals between the stomach and the brain. It tricks your brain into thinking that you have eaten sufficiently even after minimal intake.
Each procedure has its pros and cons. Discuss with your surgeon the best procedure.
Improved quality of life: After surgery, people tend to reduce risks of managing diseases such as diabetes, high blood pressure,apnoea, heart disease, reflux and arthritis Skin infections also reduce.
All major surgical procedures have risks and weight loss surgery is no exception. The complications of the surgery can be either short term or long term.
Short-term complications are mainly related to the surgery.
These include anaesthetic side effects such as excessive bleeding, infection, leaks from the intestines or stomach, development of blood clots in the legs and breathing problems.
Death during weight loss surgery is rare.
Long-term risks and complications of weight loss surgery vary depending on the type of surgery and include long-standing diarrhoea, intermittent vomiting, low blood sugar, development of hernias at the surgical site and gallstones.
Usually, most surgeons remove the gall bladder during weight loss surgery to avoid dealing with the complications of gallstones. Blockage of the intestines (obstruction) is rare but it may occur after weight loss surgery.
Can weight loss surgery fail?
Yes, it can. Usually, failure is either due to complications related to the surgical procedure or due to lack of changes in lifestyle on your part.
Usually, if you continue to eat high calorie meals after surgery and fail to exercise, then you will not lose weight as expected.
Health insurance and local hospitals
Weight loss surgery is expensive. However, if your doctor considers it absolutely necessary, speak to your health insurance provider to find out it can pay for the procedure.
Currently, we have weight loss surgical procedures being carried out successfully in local hospitals. However, most of the hospitals providing this service are in Nairobi.