Ballooning weight? Get a balloon inside you
A recent interview done with Dr Melvin Look. Featured in The New Paper on July 10, 2016.
You are the guy who looks at food from the point of entry to the point of exit. Which bit are you more concerned with?
The gastointestinal tract traverses some interesting scenery on its way from the mouth to the anus. My specialty takes me from the neck to the chest, abdomen and pelvis, but it is the stomach that excite me most.
They say that the way to a man’s heart is through his stomach, but when it comes to chronic lifestyle related diseases, it is often the stomach that is the heart of the problem. By fixing the stomach, I can often make my patients live longer and healthier.
What happens to the insides when overweight? Does the stomach and other organs expand?
Our stomach and guts do not expand even if we overeat, but the excess calories we consume are stored as fats, no only externally but in our insides as well.
The omentum is the fatty apron wraps around our organs This and other “visceral fats” make up the central obesity, which is strongly associated with cardiovascular disease and metabolic problems such diabetes.
The pot-bellied apple shaped body habitues is the typical appearance of a person with what we call Metabolic Syndrome. Some the extreme cases I have seen weigh well in excess of 200kg.
What is the sign that it’s time that an overweight person needs to see you?
Check your weight and Body Mass Index. You are in the obese range if this is more than 27.5kg/m2. (This means) it is time to loss that access weight to reduce your risk of diabetes and weight-related medical complication.
Start with exercise and a healthy diet. But if you cannot achieve sustainable weight loss despite trying to do so for more months, then it would be time to consider seeking medical help.
How do you deal with the morbidly obesity? Any cool techniques or tools?
Studies show that only 10 per cent of people with severe or morbid obesity can lose the excess weight by conservative measures alone. Surgery is often required and all of these operations are targeted at the stomach.
We have many options available, such as gastric band sleeve gastrectomy and gastric bypass. All these operations can be done by laparoscopy via keyhole surgery, and the outcomes are very impressive. They work by restricting or limiting the food intake, increasing satiety and altering the way the body handles the food.
There is now an international scientific consensus that similar surgery can also result in long term remission of diabetes by what we call “Metabolic Surgery”. These are very exciting because it means we can potentially help many diabetics avoid complications such as heart disease, blindness, amputations and kidney failure.
Have you had not-so-fat people pestering you for surgery because they have an obsession with losing weight? Can everyone go for such a procedure?
Our criteria for surgery is quite strict as any invasive procedure has its inherent risks. Our indications are always medical and never cosmetic. I have turned down many patients who request for surgery but do not need it as they are merely overweight.
For these patients, and those who are moderately obese but are not keen for surgery, we do have non-invasive option called the Endoscopic Intragastric Balloon.
This is a silicone device that is inserted through the mouth with a gastroscope in a 15-minute procedure done under sedation. The balloon is inflated with 400 to 700ml of saline and left in the stomach 12 months.
The balloon helps you feel full after a small meal and is a good tool to re-programme the way you eat. This procedure is totally reversible and the balloon is removed through the mouth with the scope, leaving no trace. Studies show there is an average weight loss about half a patient’s excess weight.
What’s the most extreme case you’ve seen?
I have been using the gastric balloon for more than 10 years and the most extreme case was a man who weighed 17kg but simply did not want surgery. He underwent three treatments with the balloon, losing between 15 and 20kg with every six months’ treatment period.
That was some years ago and we now have an upgraded device called the Spatz balloon, which can be safely left in the stomach for a year. Unlike the older balloon, it is also adjustable and this allows us to alter the size of the balloon during the treatment to achieve the effect we want.
Have you seen anyone pile the weight back on after a procedure?
Obesity surgery, or the gastric balloon, is only one part of the weight loss journey. You will need to be motivated to exercise and keep to a healthy diet plan. That is why my nutritionist ia an important part of our team.
I also see patients who start to put on weight many years after surgery (which was) done elsewhere. We deal with this by first investigating the cause of the failure. This may be due a complication from the surgery itself, but we can always find a salvage procedure to set thing right.
Having to deal with the insides every day, do you then eat kway chap (often)?
I am very much a carnivore and a nose-to-tail one at that. Kway chap sounds like a good reward after a long hard day in the operating rooms!
Make an appointment now to speak to Dr Melvin Look about weight loss surgery.
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