Many South Africans have misconceptions about metabolic surgery, but an expert says it offers obese individuals who have been struggling to lose weight with not only a highly effective means to achieve this, but far more importantly, it brings a number of health benefits for the great majority of patients.

“There are a large number of medical conditions associated with obesity including type 2 diabetes, hypertension, sleep apnoea, joint pain and osteoarthritis, among others,” says Dr Nico van Niekerk, a surgeon who practises at the Netcare Greenacres Hospital in Port Elizabeth and heads the multidisciplinary metabolic surgery centre at the facility.

“Many South Africans tend to think of this form of metabolic surgery, which is commonly known as bariatric surgery, as just a form of cosmetic weight-loss surgery. In fact, while most patients find this particular outcome pleasing, the surgery really seeks to address the health issues and risks associated with obesity, as well as to meaningfully improve the patient’s quality of life,” emphasises Van Niekerk.

“A high degree of disease resolution and very low complication rates are achieved at dedicated multi-disciplinary metabolic surgical centres,” he points out.

“At such facilities, metabolic surgery is a tried and proved option for those obese patients who qualify for it,” says Van Niekerk, an experienced metabolic surgeon who has completed close on 200 of these procedures at the Port Elizabeth centre, which is the only one in the Eastern Cape to be accredited by the South African Society for Surgery, Obesity and Metabolism (Sasso).

“This form of treatment has, for example, proved so effective for type 2 diabetes sufferers around the world in recent years that in 2015 the Second Diabetes Surgery Summit included metabolic surgery in its global clinical practice guidelines as a standard treatment option for categories of people with diabetes.”

Van Niekerk emphasises that metabolic surgery should only be undertaken at one of the 10 Sasso- accredited metabolic centres that have been established nationally, as these centres follow and comply with strict international guidelines for metabolic surgery to ensure the highest levels of patient safety and pre- and post-operative care.

Patients are, in addition, assured of internationally comparable levels of safety and care, he points out.

Strict rules and regulations with regard to patients’ dietary environment, as well as care in ICU and the wards, have to be followed at these centres, which use multi-disciplinary teams such as surgeons, endocrinologists, psychiatrists, psychologists and dietitians, among others.

The metabolic centres are able to adopt a holistic approach to weight loss and can determine the most practical solutions for each patient.

“In appropriate patients who have struggled to lose weight and regain their health for years, such holistic treatment is usually life changing,” says Van Niekerk.