Arab Gulf News quoted the occasion of GOSS meeting held in Riyadh last December and had the following talk with Dr. Muffazal Lakdawala
- Kindly introduce yourself to our readers in Arab region?
I am the founder and director of CODS (Centre for Obesity and Digestive Surgery). I also hold the position of Chairman of the “Minimal invasive surgical sciences and research center” at Saifee Hospital Mumbai. I head the Laparoscopic Oncosurgery subsection at Saifee Hospital . I am the president elect of the Asia Pacific chapter of IFSO (International Federation of Surgeons for Obesity and Metabolic Disorders) and am on the board of AETF (Asian Endosurgery Task Force).
I have tried to relentlessly work in the field of gastro-intestinal diseases. I have performed the largest number of single incision laparoscopic bariatric surgeries in the world with a high success rate. I have numerous publications in this field. I have been regularly called upon by leading institutions in India, Asia, Middle East and Europe to teach and conduct live surgery workshops and have performed live surgeries in almost every Asian country.
- How do you see Bariatric Surgery Practice in the Arab Gulf region?
Westernization, entry of quick service food chains and poor or changed lifestyles have led to a steep rise in the levels of obesity across the Gulf. Today countries like Kuwait, Qatar and Saudi Arabia are facing an obesity epidemic. Diet, Exercise and other non-surgical methods have all failed to offer long term solutions in the morbidly obese population. Bariatric surgery is the only proven method to achieve sustained weight loss and treat related disorders such as T2DM, Hypertension, Sleep Apnoea, Gout etc.
- Who should perform Bariatric procedure?
Any patient who has a BMI of 40 or above or a BMI of 35 with T2DM or Hypertension or Sleep Apnoea etc is a candidate. The surgery should ideally be performed by a surgeon trained in Bariatric Surgery with high volumes and having a team inclusive of an Anaesthetist, Endocrinologist, Consulting dietitian, Counsellor, Physical Trainer.
- How do you see the future of Bariatric Surgery?
The Obesity epidemic is rising today, there are more overweight and obese people than underweight people in the world. This coupled with the twin diseases of T2DM and Obesity called Diabesity is the biggest health problem plaguing the world. There are limited treatment options for morbid obesity. With an increasing number of weight loss drugs being taken off the shelf, surgery is the only option that leads to sustained weight loss and remission of co-morbidities like type 2 diabetes, high blood pressure, dyslipidemia, obstructive sleep apnoea etc. Hence in the current scenario Bariatric Surgery should grow faster than most other surgical specialties.
- What is the importance of long-term dietary follow-up for bariatric surgery patients?
Bariatric surgery entails altering the internal anatomy in the form of reducing the size of the stomach and or realigning the intestines. Most patients need nutritional supplementation due to this and hence it is important to follow up with the bariatric team in order to avoid deficiencies in future.
- Several reports stated that gastric by bass procedure cures Diabetes, hypertension and sleep apnea, do you recommend performing this procedure for patients with BMI less than 35?
The WHO has shown that obesity causes problems at much lower BMI’s in the Asian phenotype, because of increased visceral obesity and hence has dropped the BMI cut off by 2.5 parts for Asians. The Asia Pacific guidelines recommend that bariatric/metabolic surgery be considered for the treatment of T2DM or metabolic syndrome for patients who are inadequately controlled by lifestyle alternations and medical treatment for Asian candidates with BMI≥30.