Many South Africans today do not fully grasp the numerous health risks associated with being overweight and do not take this important aspect of their health and wellbeing as seriously as they should.
Pic "Professor Tess van der Merwe, Endocrinologist and chair of the South African Society for Surgery, Obesity and metabolism (SASSO) practises at Netcare Waterfall City Hospital and is considered to be one of South Africa’s foremost experts on obesity."
“Many people have the misconception that obesity is not a significant health issue, and one often hears statements such as ‘I may be overweight but I am healthy’. However, the health risks associated with being overweight are very real and should not be underestimated,” says endocrinologist, Professor Tess van der Merwe, chair of the South African Society for Surgery, Obesity and metabolism (SASSO) who practises at Netcare Waterfall City Hospital and is considered to be one of South Africa’s foremost experts on obesity.
“Those who have problems with their weight for one reason or another, should therefore give it the urgent attention it warrants,” adds Prof Van Der Merwe, speaking on World Obesity Day on 11 October 2017.
“This is particularly important as early intervention in addressing obesity and overweight in patients has been shown to produce the best medical outcomes in terms of preventing the development of the conditions that are so often associated with obesity such as type II diabetes, and metabolic syndrome, which is a combination of conditions such as diabetes and high blood pressure,” she emphasises.
“We see so many patients who do not recognise the health risks that are inherent to their condition and yet, upon reflection, admit that they have joint pain, their mobility is suffering severely, and they note that this is having a marked impact on their quality of life and even their mental health,” adds Prof Van Der Merwe.
“In addition, further investigation into the health of such patients frequently reveals that they suffer from one or more of the numerous medical disorders that are associated with obesity, a number of which are extremely debilitating and can potentially cripple one’s health.”
She says that in addition to type II diabetes and metabolic syndrome, conditions including coronary heart disease, and an increased risk of certain cancers are associated with obesity. “Many overweight patients are also surprised to learn after medical investigation that they suffer from potentially serious underlying medical conditions such as sleep apnoea, which is a sleep disorder, or osteoarthritis, a degenerative joint disease that is sometimes called the “wear and tear” arthritis.”
Prof Van Der Merwe, who runs the only internationally accredited metabolic surgery centre in the country at Netcare Waterfall City Hospital in Midrand, says that she emphasises this message not to alarm those who suffer from obesity but rather as an individual and collective call for them to take action to protect their health.
“There are many physiological and medical causes in every case of obesity and each person has a completely different constitution and metabolic makeup. Those who pass judgement on obese and overweight people are therefore displaying a complete lack of understanding of the complexities of this condition.
“At the same time, however, it must be emphasised that obesity represents a serious health issue both in South Africa and globally, and overweight South Africans should be encouraged to do everything in their power to get their health back on track.”
Prof Van Der Merwe says that it is not widely known that there are a number of highly effective accredited surgical options available to assist obese South Africans who are having trouble achieving and maintaining weight loss. Foremost among these are four types of metabolic surgery available at SASSO accredited centres.
“Many obese and overweight South Africans will know how difficult it is to achieve sustained weight loss through dieting and exercise alone. What is not often understood is that the metabolic surgery options available today offer the vast majority of obese individuals real hope of greatly improved health and quality of life.
“When undertaken at one of the multi-disciplinary SASSO accredited metabolic centres, these procedures offer the most effective means of tackling the condition,” adds Prof Van Der Merwe. “These treatments have a high degree of success in resolving health conditions such as type 2 diabetes that are associated with obesity.”
Dr Gert du Toit, a surgeon who runs the multidisciplinary SASSO accredited Durban Bariatric Surgery centre at Netcare St Augustine’s Hospital in association with his surgical partner, Dr Ivor Funnell, explains that the type of metabolic surgery selected will be based on the patient’s particular physiology and circumstances. All procedures are undertaken laparoscopically through small puncture holes in the abdomen.
“In the great majority of cases, where patients are treated and properly supported before and after surgery by a multidisciplinary team including a psychologist and dietician, the metabolic surgery approach achieves outstanding results and is completely life changing for patients,” he affirms. “In addition, complication rates at accredited metabolic centres are low at 0.01%, thereby demonstrating the high level of expertise within the centres of excellence for metabolic medicine and surgery at Netcare hospitals.”
Testament to this is Charmaine Thamotharan, a 44-year-old nursing sister who manages the intensive care unit (ICU) at Netcare St Augustine’s Hospital, one of the busiest units of its kind in KwaZulu-Natal. Weighing 113kg before metabolic surgical intervention, Sr Thamotharan says that she had reached a stage where she even struggled to climb a flight of stairs without becoming breathless, and found that her weight was impacting her ability to perform at work.
She also suffered leg and knee pain, polycystic ovary syndrome, high blood pressure, high cholesterol levels and was pre-diabetic, which are some of the conditions commonly associated with obesity, according to Dr Du Toit.
Encouraged by a colleague and the good results that were being achieved by Dr Du Toit’s team at the hospital, she decided to investigate whether metabolic surgery would be an appropriate option for her. After a thorough physical and psychological assessment, she finally underwent the surgery in August 2016.
“Since the surgery, my life has changed and I have never looked back,” she says. “I have lost 38kg, but more important than that, I have more energy and confidence than ever. I have regained my life and am now able to lead my ICU team with renewed vigour.”
Sr Thamotharan says she has been able to stop her medication for high blood pressure, asthma and other conditions, as all the medical conditions that she previously suffered from have been completely resolved.
“It’s remarkable, I am a 44-year-old who now feels like a 20-year-old!” she smiles. “Before the surgery I found I was exhausted after the most minor of activities; today I go to gym three times a week and have the energy to live life to the fullest.”
Sr Thamotharan says that the procedure itself was over within two hours. “I suffered no post-operative pain, and was back at work just two weeks after the operation. Not a day goes by that I don’t find myself feeling grateful that I underwent the surgery a year ago.”
“A high degree of disease resolution and very low complication rates are achieved at dedicated multi-disciplinary metabolic surgical centres accredited by SASSO. Performed at these facilities, metabolic surgery is a tried and proven option for those obese and overweight patients who qualify for it,” concludes Dr Du Toit.
Notes to editors: Centres of excellence for metabolic medicine and surgery
There are currently five centres of excellence for metabolic medicine and surgery at Netcare hospitals, offering patients access to specialised metabolic surgery, including gastric bypass procedures.
These centres of excellence are located at Netcare Sunward Park Hospital in Boksburg, Netcare St Augustine’s Hospital in Durban, Netcare Greenacres Hospital in Port Elizabeth, Netcare N1 City Hospital in Cape Town, and Netcare Waterfall City Hospital in Midrand, Gauteng. The centre at Netcare Waterfall City Hospital is the only internationally accredited centre for the treatment of metabolic conditions in South Africa, and is the principal centre for the four other locally accredited centres of excellence located at Netcare hospitals.
The dedicated multidisciplinary teams at these centres are comprised of surgeons, endocrinologists, psychiatrists, psychologists and dieticians, among others, in line with the protocols advocated by the South African Society for Surgery, Obesity and metabolism (SASSO), which is chaired by endocrinologist, Professor Tess van der Merwe. As director of the Centres of Excellence for Metabolic Medicine and Surgery of South Africa (CEMMS)(SA), Prof Van der Merwe oversees the work of the centres of excellence, including those based at Netcare hospitals.
The centres adhere to international practises to create a safe environment and to support obese patients with empathy and care. To comply with international standards, a database with statistics on each patient is maintained.
Issued by: Martina Nicholson Associates (MNA) on behalf of Netcare St Augustine’s Hospital
Contact: Martina Nicholson, Graeme Swinney, Meggan Saville, Pieter Rossouw and Alison Sharp
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