Obesity reaches epidemic proportions in the Gulf region, according to Dubai based expert

In fact, the UAE is ranked second only to Kuwait in the region in the league table of the world's fattest countries, according to estimates from the World Health Organisation (WHO). The hard facts about obesity - and its treatment - were presented to a local audience in Dubai recently by Dr Paul Sayad, General Surgeon at the American Hospital Dubai, as part of a community health event.

The World Health Organisation considers obesity to be a global epidemic and a major public health problem, with an estimated 1.6 billion adults (aged 15+) being overweight and with at least 400 million obese adults worldwide. These numbers are expected to increase dramatically (40%) in the next 10 years. Women generally have a higher rate of obesity, whilst men suffer more from being overweight.

According to Dr Sayad, of the treatments available for obesity, those including surgery have consistently proved to be the most effective. 'Obesity shortens the lifespan and increases health complications,' warns Dr Sayad.

'Obesity, which is generally defined by using body mass index (BMI) which correlates height to weight, is a complex disease caused by a combination of genetics, environment/lifestyle and psychological factors. There are several ways of tackling the problem of obesity, such as diet and lifestyle modifications but statistics show that only a very small percentage of people (3-6 per cent) will maintain their weight loss even after dieting for 4-5 years. Over the last 25 years, surgery has been proven to be the most effective form of treatment for the obese and morbidly obese (where obesity leads to other serious health problems).'

Of the surgical procedures available, the most commonly performed is the adjustable gastric banding technique, in which the surgeon fits a band around the top part of the stomach, creating a small pouch, which helps limit food intake. The procedure can now be performed through laparoscopic surgery, where the surgeon makes several very small incisions in the abdomen and works with special instruments guided by a camera (endoscope), and through which the gastric band is inserted - along with a pump placed just beneath the skin, by which the tightness of the band can be adjusted.

The goals of the gastric banding procedure are to lose at least 50 per cent of the excess body weight and improve all the other weight-related medical conditions of patients. It is often the only resort for very obese patients, for whom these procedures can offer a much improved quality of life.

'The gastric banding procedure is not new but the introduction of the laparoscopic surgical technique means that it is now much less invasive for patients, who enjoy a much faster recovery and fewer possible complications. This is not a cosmetic procedure and surgery is only one part of the overall treatment, of course,' emphasises Dr Sayad,'but the data indicates that the gastric banding procedure is safe and effective for morbidly obese patients.'

Obesity cannot be cured and is a lifetime condition that needs to be managed through dietary programmes. The gastric banding procedure is part of a holistic and multidisciplinary approach to treatment, which also includes the support of a dietician and even a psychiatrist, all of whom need to prepare the patient for a lifetime of treatment.

'The patient needs support before and after the procedure and it is not suitable for everyone,' explains Dr Sayad. 'The treatment is successful if the patient is fully committed and cooperates with the support team.

If the patient 'cheats' by not following the diet or the exercise routine, it is not going to be effective. This is why each potential patient has to be carefully screened and evaluated to ensure that there is a very good chance of success.'

Given the demands on the patient, gastric banding is only suitable for adults and the minimum age for the treatment is 18 years. Ultimately, the procedure is easily reversible if the patient cannot maintain the treatment although he/she will regain weight afterwards.