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By Muhammad Basir Roslan
KUALA LUMPUR (Bernama) -- The past decade has seen an enormous increase in the number of bariatric, or weight loss, operations performed.
Experts said this trend is likely to continue, mirroring the epidemic of obesity around the world and its rising prevalence among children.
In Malaysia, cases of overweight and obesity are now increasing at an alarming rate, with one in two Malaysians reported to be overweight or obese, leading to the rise of related chronic diseases like diabetes in recent years.
According to the 2019 National Health and Morbidity Survey, which is conducted every four years, one in five Malaysian adults has diabetes, making Malaysia as among the nations with the highest prevalence of obesity among adults in Southeast Asia. As for children, 30 percent of those aged between five and 13 years are obese.
Apart from diet and exercise, a cosmetic surgical option such as bariatric surgery is widely considered as a long-term and effective weight-loss solution.
Bariatric is often perceived as a ‘quick-fix’ weight loss surgery for those who are morbidly obese amid claims by companies of instant or quick weight loss through diet or fitness plans.
But such a claim is not true at all, according to a bariatric and upper gastrointestinal surgeon at Regency Specialist Hospital, Dr Lim Huay Cheen, noting that people are often misinformed, assuming they will come out of the surgery looking slim and shedding all the excess weight.
He also explained that weight loss after bariatric surgery is actually a gradual process that takes up to 1.5 to two years after the operation and requires consistent healthy eating and regular exercise.
In addition, the main purpose of the surgery is not to lose weight as much depends on the patient’s condition.
“We need to understand what happens during bariatric surgery and how it benefits a person’s health. It is a safe and effective intervention that may lead to the resolution or prevention of several conditions including heart disease, high blood pressure or hypertension, type 2 diabetes and sleep apnea.
“The surgery could even lower a person’s risk of premature death by 30 to 50 per cent. In short, only obese patients with certain pre-existing medical conditions and have a BMI reading of more than 32 may qualify for a bariatric surgery,” he told Bernama when contacted, recently.
UNDERSTANDING THE PROCEDURES
During bariatric surgery, Dr Lim explained that the surgeon chiefly makes changes to the digestive system, for example, the stomach and/or the small intestine, which affects how much food can be eaten and how much nutrition is absorbed.
“This is because when we eat food, it enters the gastrointestinal tract through the mouth. It then goes through the oesophagus or food pipe and into the stomach. From here, it moves into the small intestine.
“Along the way, different digestive juices and enzymes mix with the food. Nutrients are absorbed by the small intestine, and the waste and undigested food goes into the large intestine and is then passed out of the body. That is why it is important for the patient to understand the process before their surgery because there will be a relevant change in their daily food consumption,” he said.
There are different types of bariatric or metabolic surgery, which include Roux-en-Y gastric bypass and Sleeve gastrectomy.
“The former surgery reduces the size of the stomach to the size of a small walnut, which is then attached to a part of the small intestine called ‘Roux’ (hence the name). As a result, the food bypasses much of the stomach and the upper part of the intestine, and the person absorbs fewer calories and less fat from the food, but also fewer nutrients. This is the most common type of bariatric surgery.
“For the latter, about 80 per cent of the stomach is removed during the surgery, and what is left behind is a tube-like or banana-shaped pouch. Hence, the person is unable to eat as much food as before. This surgery also lowers the production of a hormone called ghrelin, which results in less of an appetite,” he said, adding that with gastric bypass and sleeve gastrectomy, patients can lose about 40-50 per cent of their body weight.
LIFE AFTER THE SURGERY
Bariatric surgery previously required the surgeon to make a big incision in the abdominal area, Dr Lim pointed out. However, with the advancement of technology, this can also be done with laparoscopy and keyhole surgery which has shortened hospital stay after surgery to just one to two days.
Laparoscopy or keyhole surgery also known as minimally invasive surgery allows surgeons to access the stomach through a small incision and a camera. It enables surgeons to perform surgery safely and effectively without a long recovery time, with less bleeding and scarring to the patient.
“But the surgery is only the start of a person’s road to better health. This is why medical professionals always evaluate a patient’s willingness to adhere to lifestyle changes after surgery during the pre-surgery consultation.
“After surgery, the patient is required to return for regular follow-up appointments and consultations where the team guides the patient on the recovery and lifestyle changes following their surgery.
When asked about life after surgery, one of the patients who is also a businessman Muhammad Naim Ibrahim shared, “From indulging in heavy meals on an almost hourly basis to limiting my food intake based on doctor’s recommendation coupled with regular exercise, I now feel motivated and energised through the day.”
“I am determined to continue down this path to become the best version of myself. Although it took me some time to realise that I need to put my health first, I’m glad I made the difficult decision to undergo this life-changing surgery,” he said with enthusiasm.
He shared that he always struggled with weight issues for most of his life. He constantly felt lethargic, suffered joint pains, and had difficulty getting a good night’s rest due to snoring. At his heaviest, he weighed about 130kg.
Today, after losing some 42 per cent of his weight after his gastric bypass surgery, Muhammad Naim is thriving and leading a healthier, active lifestyle.
Shedding the kilos and dropping a few sizes from 5XL to S with the help of a complete lifestyle change with a nutritious diet and a fitness regime has renewed his confidence and motivation to continue his fitness journey after his surgery.
Edited by Salbiah Said
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