ABU DHABI // Surgeons are warning of a new weight-loss procedure that could be lethal and yet continues to be administered in private clinics.
Botox injections in to the stomach that are putting patients’ lives at risk are being offered by doctors in the UAE despite it not being approved by the US Food and Drug Administration.
The injections, which cost about Dh15,000 a session, are made into the wall of the stomach and this supposedly makes the patients feel more full by reducing the stomach motility. Effects wear off after six months.
Dr Abdelrahman Nimeri, director of the Bariatric and Metabolic Institute at Seha’s Sheikh Khalifa Medical City (SKMC), said that it was very important for people to avoid looking for a “quick fix” when wanting to loose weight.
“Weight-loss surgery is a life-saving decision,” he said, adding that it was important that any procedure undertaken is FDA-approved and done in a multidiciplanary setting.
Botox injections could lead to severe complications such as a perforated stomach, or even death.
The BMI is the main referral centre for complications that have resulted because of metabolic and bariatric surgeries. Twenty per cent of their procedures are corrective surgery.
Since its inception in 2009, the institute has successfully treated about 70 patients who have come to their emergency rooms with severe complications because of weight-loss procedures done in other hospitals. “These patients had to be hospitalised and some took a couple of days to weeks to recover,” Dr Nimeri said.
A further 150 were seen at the BMI’s outpatient clinics.
Many of the complications were leakages or bowel blockages, mainly caused by the “technique” the surgeon used.
One patient who had botox injections developed gastric necrosis.
“His stomach basically was rotting and had holes in it,” Dr Patrick Noel, head of Bariatric Surgery at the American Surgecentre in Abu Dhabi.
“Botox injections is a fraud and lethal. It is not a safe or effective procedure to lose weight.”
Dr Nimeri said that one of the main complications of weight-loss surgery was nausea and vomiting. He blames that on the lack of “education”, which is essential for bariatric surgery, where weight-loss is achieved by reducing the size of the stomach with a gastric band or through removal of a portion of the stomach.
All of the complications were successfully resolved, he said, because patients came to the hospital in time, however, “many of the complications of bariatric surgery could be minimised by proper education and having a multidisciplinary team”.
Surgery is considered high-risk because of the multiple medical problems patients may have.
“Mainly patients who undergo bariatric surgery, by definition, are morbidly obese, so the weight constitutes a risk factor,” Dr Nimeri said. “However, if the surgery is done with a multi-disciplinary programme and all these conditions are evaluated before surgery, the risks could be greatly reduced.”
The institute has performed 1,350 bariatric surgeries since 2009.
“The only procedures we offer have to be FDA-approved and have more than five years of outcomes approved by international organisations such as the American Society of Metabolic and Bariatric Surgery or the International Federation for Surgery of Obesity,” Dr Nimeri said.
“Patients should ensure that they undergo procedures that are FDA approved if it involves drugs such as gastric balloons or endoscopic botox, in addition for other procedures.”
In both 2013 and 2014 about 4,000 bariatric surgeries were performed across the UAE. In 2015, the number was a little over 5,000.
Complications mainly occur because surgeons do not have enough expertise or the hospital is not well equipped, doctors have said.
Another issue is patients regaining the weight. Up to 20 per cent of patients regain the weight after surgery, Dr Noel said.
“In more than 90 per cent of these cases, the patient has regained the weight because they have gone back to their unhealthy eating habits. In 10 per cent of the cases it is an anatomical problem,” he said.
Half of the 150 patients seen at the outpatient clinics had complained of weight regain.
“Patients need to know that health does not equal weight,” said Dr Nimeri.
“Health equals many things, such as exercise, regular check-ups, healthy diet and other factors.”
Dr Iman Eddbali, coordinator of the Bariatric department at the American Surgecentre, said: “Before going for any weight-loss surgery one needs to ask professionals and not rely on testimonials of people online without a medical background.”
salnuwais@thenational.ae
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Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
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