Melissa Gibson spent her 32nd birthday in hospital. She weighed 148kg. Depressed and extremely overweight, she knew she had to do something.
The effects of her weight gain read like a chronic disease checklist: sleep apnoea, insulin resistance, chronic high blood pressure, fatty liver disease and terrible fatigue.
It was then that she was referred to Dr du Toit at St Augustine Hospital in Durban. “The depression and pain had reached a point that had made me a hazard to myself and those I loved,” she says.
It had taken her a long, hard journey before realising enough is enough. “From the age of 7, I started to put on weight. I have always been big, but so had my spirit. I covered up the sadness that I experienced from being obese.”
In January this year, Gibson finally underwent gastric bypass surgery. Things had come to a head when she realised the procedure would save her life.
“My final decision was made because I wanted to enjoy my life with my children. I wanted to want to live and I decided I loved myself enough to help myself.”
Six months after surgery, the help of a personal trainer and implementing a healthier lifestyle, Gibson has managed to lose 60kg and currently weighs 88kg.
“My eating habits have changed drastically and I can only eat tiny portions of food at a time. I tend to eat a few more small meals a day now.”
South Africa has the highest obesity rate in sub-Saharan Africa, with up to 70% of women and a third of men classified as overweight or obese. This is according to the latest figures by The Heart And Stroke Foundation.
Sometimes going to the gym and cutting out unhealthy food is not just going to make the weight disappear. Morbidly obese people need intervention. And this comes in the form of weight loss surgery like gastric bypass.
Obesity affects overall health in a number of ways, says Gibson’s doctor, bariatric surgeon Dr Gert du Toit. “Firstly, it shortens lifespan with metabolic diseases like diabetes and hypertension,” he says.
Du Toit adds that obesity can affect the mechanics of the body and can result in joint-related problems.
“Imagine if someone has an excess body weight of 100kg. That’s 100kg pressure on the body.”
Gastric bypass surgery is a complicated procedure. “It’s not a quick or easy fix,” notes Gibson. She explains how she was assessed by a group of medical professionals which included the surgeon, a psychologist, a dietitian, and a specialist physician.
Du Toit then breaks down the procedure into simple terms whereby keyhole surgery (small incisions) reconstructs the gastro intestinal tract to re-adjust the absorption of calories.
But it’s not plain sailing. Before her operation, Gibson was placed on a liquid and soft food diet, and for a month post-op. “The surgeon generally asks that you lose a certain amount of weight before to shrink your liver and as a benefit for your health during surgery.”
What are the criteria?
To be considered as a candidate for bariatric surgery, patients have to meet the following criteria:
A body mass index of 40 or above or a body mass index of 35-40 with significant associated health problems.
Serious past attempts to lose weight.
Dedication to drastic lifestyle changes and follow-up appointments.
Not suffering from any disease that may be causing excess weight.
Absence of drug, alcohol or emotional problems.
Understanding of the surgery and associated risks.
Du Toit says that his centre, Durban Bariatric Surgery, does a thorough assessment of candidates based on international protocol. There is also a complex set of criteria set by regulatory body IFSO.
But there are cases where patients will not be considered. Factors like well-established psychiatric illnesses and certain medical risk factors could scupper plans for considering this route.
For Gibson, the pros of having the surgery has far outweighed the cons.
“I can now run, I can jump, I can climb and I can buy lovely clothes that I actually like instead of just wearing clothes that fit me,” she laughs.
It’s a given you will live longer, enthuses Du Toit. Patients are healthier; their metabolic illnesses will be cured (as with Gibson’s diabetes); and psychologically their self-esteem and self-worth increases tenfold.
But, as with any invasive surgery, there are risks. Because this is a potentially dangerous operation, the person could die from complications.
Du Toit then stresses that the procedure should be done only by accredited surgeons. There are also immediate post-operative risks such as reconstructed valves developing leaks, but in many cases these can be corrected.
The one downside of having the surgery means patients will have vitamin deficiencies, meaning they have to be on supplements for the rest of their lives. Patients have to follow a strict diet post-surgery.
“I am on various vitamins daily to make sure I absorb the nutrients I need. I cannot drink any fizzy drinks and I don’t manage with fatty or sugary food,” says Gibson, who had to change her lifestyle.
But these changes pale in comparison with all the things she’s gained.
“My life has been saved. I wake up in the mornings and am actually glad I am here. I am free from my weight which held me down and made everything difficult.
“I now smile and actually feel happy, instead of smiling to hide the pain.”