RECLAIM LIFE WITH BARIATRIC SURGERY
THE next time Malaysia gets into a debate with its neighbouring countries over who has the best nasi lemak or chicken rice, we would do well to remember that we are also best known for being the fattest country in Asean.(1)
This dubious distinction is due to the high rate of obesity among Malaysians. The national prevalence of obesity is 30.6%, which means that almost one-third of our population is obese.(2)
Dangers of obesity
Having a body mass index (BMI) of 30 or more isn’t just about being heavier than the average person. Neither is it a question of vanity.
Obesity is a serious chronic disease, and a major risk factor for conditions like cardiovascular disease (CVD), diabetes, musculoskeletal disorders and some cancers.(3)
One of the biggest problems linked with obesity is diabetes.
We are stuck in a vicious cycle where rising obesity rates are also contributing to the increasing prevalence of diabetes in Malaysia.
Today, some 3.6 million Malaysians are suffering from diabetes, which is the highest rate of incidence in Asia and one of the highest in the world.(4)
Unfortunately, obesity and diabetes are also part of the metabolic syndrome, which increases the risk of CVD, such as heart disease and stroke.(5)
The effects of obesity don’t end there. People who are obese tend to have other health complications, such as osteoarthritis, which causes pain and difficulty in moving.(6)
Sleep apnoea is another problem, where you may have difficulty breathing while sleeping.(7)
Untreated sleep apnoea can lead to serious complications, including CVD, accidents and premature death.(8)
Complex condition
It would be easy to blame our obesity problem on the high calorie content of Malaysian food or on the unhealthy eating habits that some Malaysians have.
However, obesity is much more complex than that.
Our body weight and fat levels are regulated by a complex system of signals in the body, which control appetite, digestion, energy balance and metabolism to keep body weight and fat at a steady level.(9)
Not only is the relationship between food and body weight a complex one, there are also multiple environmental, genetic and behavioural factors that contribute to obesity.
Research is increasingly suggesting that some people are more likely to have a genetic predisposition towards gaining weight.(10)
This is why so many people struggle to lose weight.
As much as 95% of obese people who lose weight through rigorous weight-loss programmes ultimately regain their weight (or more) within two to five years.(11)
That’s why reducing obesity rates is not as simple as just telling people to eat less or to exercise more.
Surgery as an option
When severe obesity cannot be treated through diet and exercise alone, you may want to consider bariatric, or weight loss, surgery.
There are several types of bariatric surgeries that can induce weight loss. For instance, the sleeve gastrectomy is a procedure that makes your stomach smaller, so that you eat and drink less and feel full sooner.(12)
Another procedure known as the gastric bypass not only reduces the volume of the stomach, but also creates a bypass from the stomach to the upper part of the small intestine so the body absorbs fewer calories.(13)
These various types of bariatric surgery do result in significant weight loss.
According to research, many people who have bariatric surgery lose about 15% to 30% of their starting weight on average, depending on the type of surgery they have.(14)
This weight loss can help to improve more than 40 obesityrelated diseases and conditions such as type 2 diabetes, heart disease, sleep apnoea and certain cancers.(15), (16), (17)
Even better, over 90% of those with severe obesity are successful in maintaining half or more of their weight loss following bariatric surgery.(18)
On top of being effective, bariatric surgery is also a safe procedure.
In fact, it is as safe as other commonly performed operations such as gallbladder surgery, appendectomy and knee replacement.(19)
While there are no standardised national statistics about bariatric surgery in Malaysia, a recent nationwide survey estimated that there were 463 procedures carried out in 2016, compared to 158 in 2010.(20)
This shows that there is increased awareness of the surgery as a treatment option.
Is bariatric surgery right for me?
If you’re struggling to deal with obesity, you’ll be wondering if this is the answer for you.
Bariatric surgery may be an option if you have one of these(21): a BMI of 35 or more. a BMI of 30 or more, with a serious health problem linked to obesity such as type 2 diabetes, or metabolic syndrome such as high blood pressure and high cholesterol.
a BMI of 27.5 or more with a serious health problem linked to inadequately controlled type 2 diabetes or metabolic syndrome.
Most importantly, bariatric surgery is likely to be suitable for you if you are committed to changing your daily eating and exercise habits, and leading a healthy lifestyle over the long term.
Life after bariatric surgery
Bariatric surgery is not a cure for obesity. It is a method to help you get on track for a healthier lifestyle.
After you undergo surgery, you will find that it is easier to consume fewer calories.
Choosing healthy foods and beverages before and after the surgery may help you lose more weight and keep it off in the long term.(14)
As you lose more weight, you’ll also be motivated to be more physically active. You will be able to burn more fat, move around more easily and generally feel better about yourself.
One of the myths you often hear about bariatric surgery is that you will easily regain the weight that you have lost. This is not true.
In fact, the weight loss from bariatric surgery reduces hormones such as insulin and cortisol, which then improves the production of a number of other factors that reduce the uptake and storage of fat in our body.(23)
Thus, unlike weight loss through dietary methods, you have a higher chance of maintaining weight loss through this surgery due to the hormonal changes your body undergoes.(24)
Obesity is a serious health condition that you cannot afford to ignore.
While having surgery for weight loss is a major decision, you should not wait until you are severely obese before considering it as an option to manage your weight.
Talk to your doctor about whether bariatric surgery is right for you, and get all the information so that you are well-prepared for the life-changing path that lies ahead.
For more than 20 years, Ethicon has invested heavily in the development of laparoscopic surgery to transform bariatric surgery from a high-risk operation to a minimally invasive procedure for the best patient outcome.