Could surgery save SA’s fat people?

The chance of obese patients achieving a five percent weight loss in 12 months was one in 12 for men and one in ten for women.

The chance of obese patients achieving a five percent weight loss in 12 months was one in 12 for men and one in ten for women.

Published Sep 9, 2014

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Pretoria - South Africans are the fattest people in Africa, with obesity a growing problem, according to medical experts.

“The average weight of adolescent girls has increased by 10kg since 1985,” according to Professor Tessa van der Merwe, chairwoman of the SA Society for the Study of Obesity and Metabolism (Sasso).

“About 28 percent of South African teenage girls are obese (while) half of all women and a third of men have a BMI (body mass index) over 25.”

A BMI of 19 to 25 is considered normal, and a person with a BMI of 30 and above is eligible for surgery.

Bariatic surgery is new in South Africa, with about 2 800 surgeries having been performed in the country since 2007.

Only three percent of these experienced surgical complications, said Van der Merwe.

Dr Gary Fetter said sometimes surgery was the only intervention that could save obese patients from death caused by diseases such as heart failure, strokes, diabetes and hypertension.

The surgeon has done hundreds of bariatic surgeries on morbidly obese patients who cannot lose weight any other way and suffer from a host of life-threatening diseases.

Bariatic surgery refers to operations to make obese people’s stomachs smaller so that they can only eat a limited amount. This includes gastric bypasses and Biliary Pancreatic Diversion.

“Patients can expect to lose between 12kg and 20kg within a few months of having this operation,” said Fetter.

“But I didn’t get into bariatic surgery to make fat people thin. People tend to see obesity surgery as cosmetic, but it is not. It is a method to cure a range of diseases instead of trying to control them with medicine, which gets more difficult and more expensive as these diseases progress.”

Bariatic surgery costs about R150 000, but this cost is recovered within four years through savings on medicine and other interventions needed to control its deadly co-morbidities, according to Dr Andre Potgieter, vice-chairman of Sasso.

The surgeons were hosting a workshop on bariatic surgery ahead of an international conference of colon and rectal surgeons in Cape Town.

Sasso used the opportunity to ask whether South Africa’s public health sector could afford to continue to ignore bariatic surgery.

 

Before being taken to the operating table, patients are carefully screened by a team, including a psychologist and a psychiatrist, to ensure they are suitable for the operation.

“If a person’s whole life is geared to food and preparing and eating food, that person will not be suitable for the operation,” said Potgieter.

However, Van der Merwe stressed that obesity was not the result of a “lack of willpower”, but was mostly caused by a complicated interplay of genetic and environmental factors.

TV presenter Dr Victor Ramathesele said policy makers needed to be engaged to make bariatic surgery possible to patients in the public sector.

“Otherwise only a select few will benefit”. – Health-e News.

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