Children undergo weight loss surgeries in Qatar - gulfnews.com

Manama: Qatar's struggle with obesity is becoming so dire that Hamad Medical Corporation (HMC) has started performing bariatric/weight loss surgery on children, a local daily reported.

HMC said that it would have a centre of excellence in bariatric surgery within six months in order to meet the increasing need for weight loss procedures.

"We started the bariatric surgery on teenagers aged 14 to 18 and by now five procedures have been done," Dr Michel Gagner, visiting bariatric surgeon at HMC, said. "Over the next few months, we will start the procedure for those aged between eight and 14," he said, quoted by Qatari daily The Peninsula.

Studies show that 28 per cent of Qatari children are overweight and 50 per cent of Qatari boys have a BMI between 22 and 36, an indication of severe obesity.

"We have 20 teenagers in the waiting list, and in the paediatrics, there must be same number of children. These numbers might seem small, but it is extraordinary. When we speak about need for surgery for obesity in children, then we have an obvious problem," said Dr Gagner, one of the world's foremost experts in minimally invasive surgery, originator of laparoscopic sleeve gastrectomy and the first to have performed laparoscopic duodenal switch.

The first bariatric procedure in teenagers at HMC was done six months ago on a 16-year-old, who weighed 200 kilogrammes.

Only sleeve gastrectomy, a procedure that reduces the size of the stomach, is being done on children at HMC.

According to the expert, sleeve is the best for this age-group, as it needs minimal follow-up. Nutrient absorption is intact as the intestine is not cut or shortened.

Gastric banding, which involves a device that is placed around the top portion of the stomach, is not being used as it can lead to erosions and rejection of band.

"We have a disaster at HMC due to banding as it is the least successful. Each day at least three bands that had been introduced earlier are removed here. It just narrows the stomach, and the desire to eat is still there. This causes people to eat a lot and throw-up. Also over a few years, there is no weight loss. In addition, when it is done in youngsters, it can cause scarring of tissues as they grow and the revision of surgery can get complicated due to altered blood supply to nearby organs," he said.

In gastric bypass, stomach is partially or completely removed from digestion procedure. "So this requires children to take vitamin and mineral tablets. But compliance in teenagers is not very good, they do not listen to parents or doctors or do not take tablets and then they become very anaemic, have fragile bones and develop facture. Hence the procedure is not done."

The procedure here fills a major gap in providing care for obese children who are struggling with potentially life-threatening medical complications. This can help lose 70 percent of excess weight.

"Bariatric surgery in children is very unusual. However, we have realised that a number of those in their adolescence age are unable to lose wait with regular exercise and diet and they feel trapped. Parents do not know what to do. They are ridiculed at schools and they cannot participate in any activity. Then they spend more time on television and computers, with less and less time for exercise, creating a vicious cycle," he said

Not all children can go under scalpel to cut flab. It is recommended only for morbidly obese, or those with a body mass index of 40. In case of patients with chronic diseases such as uncontrolled diabetes or sleep apnea, the BMI limit is lowered to 35, the daily said.