Obesity or excess fat in the body increases risk factors for other diseases like heart attack, diabetes, high blood pressure and certain types of cancer.
In the Sultanate of Oman, about 66 per cent of the population suffers from obesity and overweight, according to 2017 statistics by the Ministry of Health. The obesity rate among women then was 40.9 per cent compared to 28.2 per cent in men.
The proportion of children under the age of five who suffer from obesity in the country exceeds 5 per cent.
Although the causes of obesity may be genetic, most cases are caused by unhealthy diet and sedentary lifestyles.
People resort to several methods to get rid of excess fat, of which is surgical intervention as a last resort when other solutions fail. But for some patients it is risky.
Obesity operations are divided into several types such as gastric balloon, sleeve gastrectomy, gastric bypass and gastric banding.
Dr Mohammed al Abri, Laparoscopic and Obesity Surgeon at the Royal Hospital, said, “Weight loss surgeries involve restricting the amount of food and inducing early feeling of fullness through sleeve gastrectomy; and unilateral or bilateral duodenal diversion operations which lead to a physiological state that reduces food absorption.”
He mentioned that sleeve gastrectomy, cutting or stapling reduce the size of the stomach to remain 15-20 per cent of the original size by removing a large part of it using surgical staplers to stay in the shape of a banana. “It’s idea is based on reducing the amount of food and controlling hunger. Advantages of this include reducing ulcers and emptying syndrome. It has proven effective in losing weight and preventing obesity-related diseases’’, he explained.
As for the two-way duodenal diversion, it is done by creating a gastric bag that holds a capacity of 30ml and connecting it to the small intestine. Dr Al Abri said, “It is one of the oldest operations that has existed for more than five decades, with excellent long-term results. Its main function is to reduce the amount of food consumed, as well as to change the intestinal hormones related to hunger, food and sugar path. Results are better and longer lasting”.
The doctor, who holds a Canadian and American fellowship in advanced laparoscopic surgery and obesity, indicated that “due to the change of course, the patient needs to be on supplements and to stay away from smoking and anti-inflammatory drugs to avoid complications”.
Unilateral duodenal diversion is done through reducing the size of the stomach through a bag of approximately 60ml and diverting the path to the intestine so that it goes beyond the first two metres of the intestine and thus reduces absorption.
Another type is a gastric sleeve with a duodenal switch. The stomach is stifled while food passes through the duodenum. It passes over the last 100 cm of the intestine only, thus reducing absorption. Dr Al Abri commented: “It is the best operation in terms of results and improving health problems. Yet, it is the most complex, as the patient needs continuous follow-up and examination of vitamins and minerals frequently.”
The doctor said each type has advantages and complications, and the more complex the operation, the more useful it is for weight and health improvement. “Other procedures like endoscopic band ligation and diversion of the small intestine are safe when they are performed by a specialised surgeon on an appropriate patient, and their complications are in varying proportions’’, Dr Al Abri said.
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