Many South Africans have misconceptions about metabolic surgery, but an expert says that 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 as well.
“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 Netcare Greenacres Hospital in Port Elizabeth and heads up 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 Dr 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 proven option for those obese patients who qualify for it,” says Dr Van Niekerk, who is a highly 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 South African Society for Surgery, Obesity and metabolism (SASSO).
“This form of treatment has, for example, proved so effective for type II 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.”
Dr 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 patient safety and pre- and post operative care. Patients are, in addition, assured of internationally comparable levels of safety and care.
Strict rules and regulations with regard to patients’ dietary environment, as well as care in ICU and wards have to be followed at the SASSO-accredited centres. Training facilities with specialised technology and equipment are also used.
The dedicated multi-disciplinary teams at the SASSO centres are comprised of surgeons, endocrinologists, psychiatrists, psychologists and dieticians, among others, in line with the protocols advocated by SASSO, which is chaired by well known endocrinologist, Professor Tess van der Merwe.
“The SASSO-accredited metabolic centres are able to adopt an holistic approach to weight loss, and can determine the most practical solutions for each individual patient. In appropriate patients who have struggled to lose weight and regain their health for years, such holistic treatment is usually life changing,” says Dr Van Niekerk.
The centre at Netcare Waterfall City Hospital in Midrand is the only internationally accredited centre for the treatment of bariatric and metabolic conditions in South Africa, and is the principal centre for the four other locally accredited metabolic surgery centres.