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Bariatric surgery: what is available in UAE

1) Intragastric balloon: This is a newer kind of weight-loss procedure in which a saline-filled silicone balloon is placed in the stomach. It helps patient lose weight by limiting how much they can eat and makes them feel fuller faster. It is usually recommended when the patient is overweight or obese, and must be accompanied by a commitment to a healthier lifestyle. When the balloon is eventually removed however, many….. patients tend to regain some of the weight they had lost.
2) Sleeve gastrectomy: A sleeve gastrectomy is a surgical weight-loss procedure that is usually performed laparoscopically…..(or endoscopically?). Small instruments are inserted multiple small incisions in the upper abdomen, and about 80 per cent of the stomach is removed, leaving a tube-shaped stomach about the size and shape of a banana.
Limiting the size of the stomach in this way restricts the amount of food patients are able to consume. In addition, the procedure prompts hormonal changes as the food passes quickly through the stomach to the intestine, leading to an increase in the patient’s basal metabolic rate.

3) Gastric bypass: In this kind of weight-loss procedure, a portion of the stomach can be sealed off to reduce the size of the organ, and the remaining stomach pouch is connected to the small intestine. Food thus bypasses most of the stomach and the first part of the small intestine to reach the middle part of the intestine. In another type of gastric bypass, about 80 per cent of the stomach is removed and the organ is connected to the end of the small intestine. This reduces how much the patient can eat due to the reduced volume of the stomach, and the absorption of nutrients is reduced since food bypasses most of the small intestine.
Typically, the maximum capacity of the stomach decreases from 100-1,500 cubic centimetres to just 30-40 cubic centimetres after a gastric bypass. The resulting hormonal changes from these surgeries help weight loss in patients.

Things to know

• Cost: Dh32,000 – Dh60,000
• 70 per cent of patients who seek bariatric surgery are women
• On average, patients lose 70-90 per cent of excess weight within a year after a gastric bypass, and 50-70 per cent of excess weight after a sleeve gastrectomy.
• Patients must continue to take multivitamins throughout their lives after undergoing bariatric surgery. However, recent advances mean that patients can also opt for chewable pills or patches.
• Bariatric surgeries help in losing excess weight, and help resolve comorbidities like diabetes, sleep apnoea, hypertension and joint pain. In fact, 90 per cent of patients are able to resolve their diabetes completely. Of course, the surgery must be followed by appropriate lifestyle modifications for patients to achieve these results.
• Pre-surgery: Patients have to undergo psychological assessment and lifestyle modifications. Before the procedure, they also have to be on a high-protein diet for a while, and graduate to a liquid diet.
• Post-surgery: Patients must follow a liquid diet, before moving to pureed foods, soft solids and then finally solid food. Moving to solids usually takes nearly two months as the body adjusts to its new equilibrium.
• Surgical risks: Risks have reduced considerably over the years and occur in just about one per cent of procedures. They include excessive bleeding, surgical site infection, adverse reactions to anaesthesia, blood clots, breathing problems, gastrointestinal leaks and death.
• Post-surgery complications: These include bowel obstruction, dumping syndrome that causes diarrhoea, nausea or vomiting, the development of gallstones or hernias, low blood sugar, malnutrition, stomach perforations and ulcers. The resulting weight loss can also lead to body aches, exhaustion, feeling cold, dry skin, hair thinning and loss and mood changes.
Adverse outcomes

January 2012: A Sharjah-based Arab resident with three children died after undergoing bariatric surgery. Weighing 96 kilograms, she had been suffering from knee and back pain, and bariatric surgery was advised. Post-surgery, she experienced bleeding in her stomach and could not eat or drink. She weighed just 40 kilograms when she died.
August 2013: A 37-year-old Arab man with a weight of 200kg wanted to improve his marriage prospects and opted for bariatric surgery. He died of complications following a gastric bypass in Al Ain.
May 2016: A 38-year-old Palestinian man died after he suffered a heart attack after bariatric surgery. He had reportedly weighed 245 kilograms before bariatric surgery.
September 2017: Eman Abdul Atti, reportedly the world’s heaviest woman, died at a hospital in the UAE. She had undergone bariatric surgery in India earlier in the year, and had appeared to be doing well afterwards. Her death was attributed to complications from underlying comorbid conditions, including heart disease and kidney dysfunction

Source: Gulf News

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