The big issue

To reference Suzie Orbach, fat may once have been a feminist issue, but it is fast becoming a surgical issue for the parents of morbidly obese teens.

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By  Joanne Bladd Published  December 6, 2006

Obesity surgery is not cosmetic surgery; it should be reserved for morbidly overweight patients. To reference Suzie Orbach, fat may once have been a feminist issue, but it is fast becoming a surgical issue for the parents of morbidly obese teens.

The decision by the UK’s notoriously conservative National Institute of Health and Clinical Excellence (NICE) to come out in favour of bariatric surgery for severely overweight children has ignited fierce conflict over the ethics of trading drastic measurements for drastic measures.

It’s a debate that could become a regular topic around Dubai dining tables, as the launch of the Emirate’s first obesity center sees local parents sizing up the issue of gastric bypass procedures for their own adolescents.

The center, a collaboration between the Dr Sulaiman All-Habib Medical Group and Welcare Hospital, is fronted by Dr Gabi Wazz, a consultant in general surgery, who is open in his belief that surgical intervention for children as young as 14 is both appropriate and necessary when behavioural interventions fail.

The prospect of ushering a child into the bariatric breach is enough to leave a bad taste in anyone’s mouth, but supporters argue that the cost of potential comorbidities, both physically and financially, is high enough to override an emotive response to a medical issue. And for many medical professionals, their objections have been silenced by the severity of the cases they see regularly in their practices.

Both medical planes and opinions are shifting. While ten years ago, type 2 diabetes was almost exclusively an adult concern, it’s now a common diagnosis for children as young as 10. Though the psychosocial impact of adolescent obesity is, of course, huge, it pales beside the potential medical complications for a 17,18 or 19 year old who has had diabetes for a decade.

When we find ourselves weighing up the pros and cons of bariatric surgery for our teens, clearly, we have already failed to protect them. Certainly in the UAE, when it comes to preventive measures, we have barely scratched the service.

We need more healthy eating, better activity patterns, more proactive physicians and better educated parents; but what we have is a pandemic of morbidly overweight children. Bariatric surgery may be an extreme response to an extreme situation, but where behavioural interventions fail, it may be the best option we have.

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