UAE school teacher pleads for help for obesity surgery

Shannon Pipes far exceeds the BMI requirement for an operation - but medical insurance only covers surgery once you become ill

Abu Dhabi, United Arab Emirates, January 1, 2019.  
STORY BRIEF: School worker is hoping a hospital will offer her free bariatric surgery as she can’t afford it herself and the Dh40,000 procedure is not covered by health insurance.  Shannon Pipes wants to drop from !75kg to 100kg. 
Victor Besa / The National
Section:  NA
Reporter:  Nick Webster

A teacher who struggles with her weight says she hopes a private hospital will give her free bariatric surgery to turn her life around.

Shannon Pipes, who weighs 173 kilograms, comes from a family of people with weight issues but said she has had difficulty controlling her eating.

The American, an assistant principal at an Abu Dhabi school, is unable to fund the Dh40,000 procedure herself and it is not covered by her health insurance.

“I’ve battled weight loss for 20 years, trying all kinds of diets,” she said.

I've reached a certain point in my life where I think it is now or never

Her policy states she must have a related illness or disease for her insurance company to pay for surgery.

Mrs Pipes, 35, spoke to The National in the hope a private medical provider offered her the surgery. Such waivers are not unusual and hospitals often undertake cases on the grounds of publicity or charity.

Doctors said dieting and exercise should be a priority and surgery a last resort, but her case puts the spotlight on a system that does not offer such treatment until a person becomes ill.

Mrs Pipes said she wanted to reduce her weight to 100kg.

“I’m at the point where I would now happily consider bariatric surgery," she said.

“I went directly to a bariatric centre to see if my health insurance would cover it.

“They said no as it is considered a cosmetic procedure costing Dh40,000 that I could not afford.”

Although bariatric surgery is widely offered in the UAE, only the Daman Thiqa medical package given to Emiratis covers surgery.

Mrs Pipes, who lives in Shakhbout City, said she found it difficult to exercise regularly or maintain a regular eating pattern.

She said working until 8pm most days left little time to cook healthy meals at home, so she chose takeaways from McDonalds and Chili’s that are loaded with saturated fats, salt and sugar.

“I have tried the keto, Atkins and an egg fast diet and also a liquid diet called Optifast that bariatric surgeons recommend,” she said.

“I went from 170kg to 130 kg but the stress of my job and overeating then saw me put the weight back on again."

Hospitals set strict criteria patients must meet before they are considered suitable for surgery.

Bariatric procedures do not come without risks, so patients are advised to try all other weight loss methods first.

“Surgery should always be a last resort,” said Dr Ghassan Mustafa, a gastroenterologist at Burjeel Speciality Hospital in Sharjah.

“There are many kinds of bariatric procedures available to patients, but there is the potential for complications so it is not something hospitals will consider lightly.

“The most common is a gastric sleeve, to make the stomach smaller, but it also has the highest failure rate.

“About 30 per cent of patients who have this surgery will put the weight back on again.”

Bariatric surgeons at Zulekha Hospital in Dubai said doctors struggled to keep up with the demand for corrective surgery, with obesity procedures increasing by 425 per cent between 2015 and 2018.

Dr Mustafa referenced studies that suggested patients who underwent stomach surgery could also be at an increased risk of stomach cancer.

Surgery will only be considered in patients with a body mass index of more than 40.

The calculation measures height and weight to give doctors a general indication of a healthy size for a patient, although it does not take into account general body structure and muscle mass. In adults, an ideal BMI is between 18.5 and 24.9.

At 156 centimetres tall, Mrs Pipes has a BMI of 55, far above the benchmark recommendation for surgery.

Doctors will consider alternatives to surgery such as medication or a gastric balloon, if lifestyle changes fail to aid weight loss.

A patient would need to show there is a serious health risk from diabetes, liver damage or heart failure before surgery would be considered. Any kind of surgery should always be a last resort

Balloons are inserted into the stomach via a pill or endoscope. Once inflated they can reduce appetite, aiding weight loss of up to 22kg within four months.

“Insurance companies are strict on when they will pay for bariatric surgery and for good reason,” Dr Mustafa said.

“A patient would need to show there is a serious health risk from diabetes, liver damage or heart failure before surgery would be considered an option.

“And this would also only be done on the understanding the patient has tried to modify their diet and increased exercise to lose weight.

“Any kind of surgery should always be a last resort.”

Mrs Pipes witnessed drastic results when her mother, Sherry, underwent surgery when the procedure was in its infancy in the early 1990s.

“My mum was one of the first patients to have bariatric surgery in the US 25 years ago, with a gastric bypass,” Mrs Pipes said.

“She dropped from 147kg to 86kg due to the operation and lifestyle changes. I’m confident I can do the same.

“I want to lose weight to be able to be healthier and happier. I’ve had infertility issues and I think my weight is contributing.

“I’ve reached a certain point in my life where I think it is now or never.”