Diet, exercise and lifestyle are answer to obesity, forum told

Doctors say changes in lifestyle are necessary in addition to surgery to keep obesity at bay.

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ABU DHABI // Doctors at a lecture offered a second opinion for people who are considering going under the knife instead of staying on the treadmill. Surgery alone is not the solution and not every person who is overweight or obese is eligible for weight loss surgery, doctors said at a free public forum held at Sheikh Khalifa Medical City (SKMC) on Tuesday.

"Treating morbid obesity begins and ends with diet, exercise and positive lifestyle changes, even with surgery," said Dr Abdelrahman Nimeri, the director of SKMC's Bariatric and Metabolic Institute and head of general thoracic and vascular surgery. Dr Nimeri said he advised his patients, for instance, to take the stairs instead of lifts and to park their cars slightly farther away from the entrance of buildings - even if they are scheduled to have surgery.

The lecture was intended to answer the questions of people considering gastric bypass surgeries, including sleeve gastrectomy and adjustable gastric banding, in which doctors use different methods to shrink the stomach and alter the digestive system to induce weight loss. "The purpose of these lectures is to educate, because the decision for elective weight reductive surgery is probably the most important decision a patient will make," said Dr Nimeri.

"Elective bariatric surgery is not for everyone who is morbidly obese, it is a choice, because surgery is not a cure for obesity, but a tool that can help fight the problem." Under guidelines established by the National Institutes of Health, the US government's medical research agency, two types of patients qualify for such surgeries: those who have a body mass index (BMI) of more than 40 and are classified as morbidly obese, and those who have a BMI of more than 35 and accompanying diseases, such as hypertension or diabetes.

"A responsible doctor would refuse to perform surgery on an obese patient who, for example, has a BMI of say 37 but no complications, but wants to desperately lose weight," said Dr Nimeri. Such patients should first be referred to a psychologist and a nutritionist, he said. Gatric bypass surgeries generally cost between Dh20,000 to Dh27,000, depending on the procedure, although Emiratis can have them covered by the health insurance plan for nationals.

For some of those who attended the lecture, the surgery option still held its appeal. Hanan, who declined to provide personal details, said she has been overweight all of her life. Currently in her 30s, she has been described as morbidly obese by doctors for more than eight years. "I have tried dozens of diets but nothing works for long, and I want to live to see my children grow up," said Hanan, who attended the lecture as a first step towards preparing for her surgery.

Mohammed al Zaabi, 39, underwent gastric bypass surgery on January 26 and weighing 151kg. Less than two months later, he has lost 28kg. Mr al Zaabi said he no longer suffers from severe hunger pangs, and said the surgery was the best decision of his life. "It has affected my life at work and at home so positively; I sit in my chair more comfortably, I play with my kids without becoming out of breath, I can look towards my future with optimism now."