- POSTED: 26 May 2014 07:55
Doctors recommend procedure for some obese patients but warn that success still depends on healthier eating, exercise.
SINGAPORE: Going under the knife to lose weight is increasingly being considered as an option for those suffering obesity-related co-morbidities, such as diabetes and hypertension, figures released by five public hospitals show.
The spike in interest in bariatric surgery – a procedure that decreases the size of the stomach to sizeably limit a patient’s food intake – is against the backdrop of rising obesity rates here, alongside a traditionally high drop-out rate for exercise and diet plans.
Singapore General Hospital (SGH), which has seen a more than 12-fold increase in such surgeries in the past five years – from seven in 2009 to 88 last year – said roughly 40 per cent of patients seeking help to lose weight through exercise and healthier eating alone do not return for follow-ups.
Dr Jaideepraj Rao, senior consultant and director of the Bariatric Surgery Programme in the Department of General Surgery at Tan Tock Seng Hospital (TTSH), estimated that nine in 10 quit the programmes.
To more effectively reduce the risks of obseity-related conditions, doctors such as Dr Rao recommend surgery for weight loss for certain groups of obese patients – those with a Body Mass Index (BMI) above 32.5 – although he stresses that success of the surgery is still affected by subsequent diet and exercise plans.
The BMI is calculated by dividing your weight in kilogrammes by the square of your height in metres – anyone with a value above 23 is considered to be above the healthy weight range.
Dr Rao said his hospital performed 21 bariatric surgeries in 2011, a figure that rose to 57 last year. So far this year, there have been 28 such surgeries.
Most of these patients lose more than half of their excess weight, said Dr Rao, but added that 10 to 15 per cent of his patients regain a little of their lost weight later.
“There is no one magic answer,” said Dr Rao, adding that surgery had to be supplemented by counselling, a diet plan and exercise.
Two other doctors, on the other hand, are more selective about giving the green light for surgery as a weight-loss option.
National University Hospital’s Dr Asim Shabbir said: “Patients are encouraged to try less invasive methods of weight loss, such as diet modification, exercising and medication. It is only when these methods prove ineffective after a period of time that surgery is recommended.
“And surgery has to be complemented with lifelong regulation of diet and healthy behaviour.”
Agreeing, Dr Shanker Pasupathy, senior consultant in the Department of Vascular Surgery at SGH, told TODAY that his team is selective about offering surgery to patients. Dr Pasupathy gets roughly 1,000 such referrals a year.
At TTSH, post-surgery patients go on a liquid diet for two weeks, then puree for the next two weeks and semi-solid food for another two before returning to normal food. Doctors follow up with patients two weeks after surgery, then a month, and then every three months thereafter.
Patients are also put on support groups, something that SGH also has, where they meet with other patients and share their challenges while supporting one another through diet and exercise plans thought out by the hospitals.