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Our Nutritionists




Lea Debian

Lea

Dietician & anti-aging program coordinator

Evaluate patients for Anti - Aging program.
(Dubai)



Nadine Andari

Nadine

Clinical Dietician

Masters in Clinical Nutrition - American University of Beirut
(Dubai)



Ghina Hamoui

Ghina

Bachelor in Food Sciences & Dietetics

Permanent guest at Abu Dhabi TV
(Abu Dhabi & Khalifa City)



Nebal Ghandour, BSc.

Nebal

More than ten years of experience in Clinical Nutrition.

Medically supervised weight reduction programs.
(Sharjah)



Zeina Wahbi

Zeinah

Dietitian

Medically supervised weight reduction programs
(Al Ain)



Manar Daniel

Manar Daniel

Dietitian

Bachelor in Clinical Nutrition and Dietetics
(RAK)


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Surgical solutions for obesity: are they safe? Are they effective?

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Articles - Nutrition

Dr Max Sawaf, medical director of CosmeSurge® compares balloons to gastric bands and gastric bypass.

Obesity is not just caused by too much eating and not enough exercise. It is a complex disease where stress levels, hormonal balance, enough sleep, emotional eating and food intolerance play a major role. The solution is not as simple as slapping a band, inserting a balloon or performing a bypass and or advising the patient to eat less and exercise more. Obesity is a complex, serious and progressive disease and you need to find a team that is passionate about helping you find a good and safe long term solution. 

Gastric Bands for obesity. Also called Lap bands since it is inserted using key hole surgery or laparoscopy. Since the Lap-band is implantable using minimal-invasive techniques, patients that are extremely obese with heightened surgical risks benefit from the conservative entry to the abdominal cavity. Due to the absence of upper abdominal incisions, the incidence of wound-healing complications, wound infections, postoperative pain as well as incisional hernias are drastically reduced. In addition, this method is cosmetically advantageous due to the absence of a large scar and it is fully reversible. The absence of lasting modifications to the anatomy of the intestinal tract allows for relatively easy restoration to the original state by simply removing the band, which can be done using laparoscopic techniques in most cases. 

The band is applied around the stomach below the gastro-esophageal junction. On the inner lining of the band there is a longitudinal balloon (like a bicycle tire). This band is attached to a subcutaneous port through a small tube. The band is left empty at time of surgery but is thereafter gradually filled with fluid by injection through the subcutaneous port. It is thus possible to vary the opening in the stomach after surgery. 

The band system can be regarded as putting a straight-jacket around the stomach. 

The small gastric pouch created above the band limits the amount of food that a patient can eat at any one time and will result in a feeling of fullness after eating a small amount of food. 

The band induces an early feeling of satiety and thereby decreases food intake. The amount of weight you lose depends both on the band and on your motivation and commitment to a new lifestyle and eating habits. The success rate in the hundreds of patients that we operated on is around four out of five. Complications such as esophageal dilatation may occur especially if the patient insists on having too many refills and tightening of the band without any changes in their eating habits and lifestyle. 

Gastric Bypass for morbid obesity. Gastric bypass has evolved over the years to decrease the serious side effects that were encountered with the earlier procedures such as chronic diarrhea, dumping syndromes and liver failure. 

While improvement in the technique has helped decrease these side effects and made this procedure popular again, they are still encountered in some patients. One out of one hundred patient ends up staying in the intensive care unit for weeks and others die due to leakage from the suture line. Proponents claim that this procedure is more effective in reducing weight for those who survive the operation especially the ones with a sweet tooth. Should you decide to proceed with this operation, you need to chose a surgeon who has done more than 500 cases (as his complication rate decreases with experience) and a hospital that is experienced in such an operation and in handeling complications.

Gastric balloons with no surgery. This procedure is performed by gastroenterologists. The idea is to place an empty balloon through the mouth using an endoscope under heavy sedation. Once the balloon is in the stomach, it is inflated to give patients a feeling of fullness. The balloon has to be removed within six months as keeping it longer risks having the balloon being digested by the stomach resulting in intestinal obstruction and requiring major surgery. 

The procedure is simple and produces no scars; hence it is very appealing for patients. The problem is that the long term success rate of this procedure is very low (only one out of five patients does benefit - too many doctors hide this fact from their patients). 

To summarize, gastric band surgery has the best risk-benefit ratios among all surgeries available today for obesity. It induces sustainable weight loss in 50-60% of patients and therefore it leads to a healthier life with fewer risks for obesity related secondary diseases. 

Having said that the fact remains that neither gastric banding, gastric balloons nor gastric bypass are effective in the long term unless other issues such as emotional eating, hormone imbalance, severe stress or depression, lack of exercise and low awareness of the importance of avoiding food with a glycemic index are addressed. 

At CosmeSurge® I work with a team of experts who stand ready to maximize your chances of success by breaking your metabolic code and uncovering the mystery behind your obesity and guiding you to a healthier life. For more information please feel free to email me at  This e-mail address is being protected from spambots. You need JavaScript enabled to view it

 

 


Last Updated on Saturday, 26 November 2011 10:17
 
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