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Bariatric surgery not magic but good intervention against obesity: Expert
BY MARIECAR JARA-PUYOD July 21, 2018
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DUBAI: A surgeon favours the treatment of obesity on adolescents through bariatric surgery while saying that lifestyle and diet modifications are a big help.

Obesity is the condition whereby a person has gained excess fat leading to debilitating health. It is known through the body mass index (BMI) derived from his weight in kilogrammes and meter square, and his height in metre squared.

Dr Nazim Alrifai, general surgeon for over a quarter of a century who has specialised in bariatric surgery since 2002, told The Gulf Today his youngest patient was a 16-year-old completely apprised of his health and the procedure, monitored by the medical team with full family support.

A bariatric medical team with the surgeon as the lead consists of a clinical dietician, psychologist, endocrinologist, gastroenterologist and radiologist.

“Just imagine what kind of life a child on the morbid side of obesity would have throughout the rest of his life,” he said.

Alrifai was interviewed ahead of the “Exclusive Batriatric Support Group Get-Together on Obesity and Its Risks” of the Zulekha Hospital on Thursday night in Dubai.

World standards indicate that at any age, an individual on the “morbid side of obesity” has BMI of over 35; obese, 30 to 35 BMI; and overweight, 24 to 30 BMI.

Alrifai said an obese child’s poor health within five years would worsen within a decade if neglected: “Children are our future. We should cut obesity as soon as possible.”

He termed obesity as a “global disease” because the very nature of the human body is not akin to the rapid modernisation and upsurge of technology; not only about unhealthy and inappropriate food intake.

Alrifai described the stored huge amounts of fat as “toxins” slowly severely affecting every organ such as the brain, blood vessels, eyes, the endocrine system and the heart.

“Bariatric surgery is not magic. It is not the solution. If you lose weight normally, we could (defeat) obesity. But if we could not lose weight with all the effort, surgery is the intervention especially with the proper procedure,” he said.

Alrifai added the youngest most recent bariatric surgery patient in Saudi Arabia was a 12-year-old.

On Thursday night, Mohammed Al Sheemi shared his rollercoaster ride with all forms of diet he had come across with to get rid of overweight-ness and obesity from childhood.

It was one diet to the next, good for two to four months until he would return to over-eating and regain between eight and 10 kilos. Consequently, he became easily exhausted, went through numerous bouts with difficulty in breathing, low oxygen levels, fainting, and cholesterol and blood pressure shoot-ups. He became sluggish because of insufficient restful sleep.

Because the engineer was going through sleeplessness and unrestful nights, he suffered a near death experience when he had slept while driving. In shopping for clothes, the XXL size proved to be unsuitable for him anymore.

These two became the deciding factors for his bariatric surgery. After fully assessed, Al Sheemi went for the mini gastric bypass two months back.

“I feel great. I told my wife I would be playing my favourite sport, squash, again. My wife is so happy now because I (no longer) snore.”

He was given a special packed diet by clinical dietician Dina Albeltaji three weeks prior the medical procedure.

Since the surgery, Al Sheemi has been eating in small quantities but first he must tryout which food suits him.

Saying he is down to 100 kilos from 120 kilos since two months ago, Al Sheemi also told this reporter he already knows how to satisfy hunger without “eating in full.”

“If I only knew how to eat then properly and correctly, then I would not have suffered much.”

From various websites are the following obesity facts and figures as of 2017:

. By the end of 2017, out of the 7.5 billion people worldwide, 775 million were obese from all age categories sliced into 650 million adults and 125 million children from under age five to 19.

. The Top Three Most Obese Countries as of July 2017 were US (109 million), China (97 million) and India (66 million).

. The Top Three Most Obese Regions as of July 2017 were the Oceania comprising of Cook Islands, Samoa, Tonga, Nauru, Palau, Niue and Marshall Islands; the Middle East specifically eight nations including the UAE, Saudi Arabia, Libya, Oman, Jordan, Egypt and Kuwait; and South America particularly Brazil, Mexico, Argentina, Peru and Chile.

. In the Most Obese Countries by Percentage as of July 2017, the UAE ranked 12th among Top 20 countries at 37.20 per cent.

. As of July 2017 with 6,350,738 adults of the total 9,400,145 population in the UAE, 2,362,475 were obese.

On child obesity, a 2017 research by the Imperial College of London (ICL) and the World Health Organisation (WHO) had determined that obese children would greatly outnumber their underweight counterparts worldwide by 2022.

“Obesity rates in the world’s children and adolescents increased from less than one per cent (equivalent to five million girls and six million boys) in 1975 to nearly six per cent in girls (50 million) and nearly eight per cent in boys (74 million) in 2016. Combined, the number of obese five to 19-year-olds rose more than tenfold globally, from 11 million in 1975 to 124 million in 2016. An additional 213 million were overweight in 2016 but fell below the threshold for obesity.”

Lead research author Prof. Majid Ezzati from the ICL-School of Public Health attributed the global alarming rates to the “impact of food marketing and policies with healthy nutritious foods too expensive for poor families and communities.”

WHO-Non-Communicable Diseases Surveillance and Population-Based Prevention programme coordinator Dr. Fiona Bull said: “Countries should aim particularly to reduce consumption of cheap, ultra-processed, calorie dense, nutrient poor foods.”

She said governments should encourage more outdoor recreational games and sports than technology-based fun for children.

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