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Dato' Dr Haron Ahmad reveals the dangers of being overweight, and how the Severe Obesity Centre at KPJ Damansara Specialist Hospital can help.


Severe obesity is becoming an increasingly common problem in Malaysia. Fast food chains lure children in by hawking attractive toys, offering older diners the option to upgrade to a bigger set meal for just a few ringgit more. With a change in diet, there are more and more overweight Malaysians who suffer health problems such as diabetes, shortness of breath, sleep apnoea, back pains and other weight-related illnesses.
It seems obesity is a clear and present danger, but there is hope yet. The Severe Obesity (Bariatric) Centre at the KPJ Damansara Specialist Hospital, a member of the KPJ Healthcare Bhd, can offer help and advice to the obese.

Dato' Dr Haron Ahmad.

Weighing the Issue
"Asians who have a Body Mass Index (BMI) of 37 or above are considered severely obese," points out Dato' Dr Haron Ahmad, Consultant Surgeon in Advance Laparoscopic and Obesity at Damansara Specialist Hospital. Currently, 12 per cent of Malaysians are overweight, while 4 per cent of the population is severely obese, says Dato' Dr Haron. There is also another chilling term - morbid obesity - used to describe people who are severely obese, and also diagnosed with illnesses such as high blood pressure, diabetes, and other metabolic diseases.
Many people are unaware of the dangerous complications that obesity can cause. "I had an obese patient with appendicitis and we could not determine if he was in pain; he could not feel us pressing because of all the fatty layers," reveals the doctor. "The next thing we knew it had ruptured and it was difficult to clean up afterwards, again because of layers and layers of fat tissues." With the current AH1NI pandemic, the obese or severely obese that catch the virus are at risk of developing further complications that can lead to death. It's obviously an issue that needs to be addressed.
But why are people getting bigger? "The main reasons point to unhealthy food consumption, association with the obesity gene, and other environmental aspects," says Dato' Dr Haron. He also notes that when people know they are gaining weight and choose not to do anything about it, the weight escalates. "They become sedentary and continue with their bad eating habits."

When patients come here, many are on the verge of giving up"
Dato' Dr Haron

Before and after of an Obese patient, treated at KPJ Damansara Specialist Hospital.

Comprehensive Treatment
The Severe Obesity Centre was set up last year by Dato' Dr Haron and Datin Paduka Siti Sa'adiah Sheikh Bakir, Managing Director of KPJ Healthcare Berhad. With Dato' Dr Haron's expertise in obesity surgeries, the centre offers everything from consultation and counseling, up to surgery. "This is the first comprehensive centre in Malaysia with a team that includes consultants, a psychologist and a dietician," he says. There is also a support group that patients can opt to attend after surgery. "When patients come here, most of them have unsuccessfully tried to lose weight, and many are on the verge of giving up," says Dato' Dr Haron.
Due to demand, the centre will be expanding next year. Dato' Dr Haron works closely with a visiting consultant bariatric surgeon from the United States, Dr Paul B. Wizman, who will perform surgeries at the hospital when needed. Recently,
Dr Paul flew to Malaysia with two patients from the US. "We have overseas patients who have heard about the centre," says Dato' Dr Haron, who is currently assisting in research on obesity surgery in India.

Types of Severe Obesity Surgery
There are three main surgery options for severe obesity: Laparoscopic Gastric Banding, Laparoscopic Gastric Sleeve, and Laparoscopic Gastric Bypass:
• A gastric banding surgery is where a hollow band is wrapped around a small portion of the stomach creating a small pouch. This restricts the amount of possible food intake.
•    A gastric sleeve surgery is where part of the stomach is stapled to leave a smaller 'banana shape' portion, which will result in smaller absorption of food.
•    Gastric bypass surgery divides the stomach into two compartments using staples, a much smaller one above, and the remnant below. The small intestine is then joined to the smaller, newly created  stomach.   Most patients will subsequently eat less, and even experience loss of appetite.
All surgeries are done using a laparoscope inserted in the abdomen through small incisions to the stomach.

Staff of Obesity Center at KPJ Damansara Specialist Hospital.

Food for Thought
"With a smaller stomach after surgery, the production of ghrelin, an appetite hormone, will be reduced too," explains Dato' Dr Haron. This, according to him, will greatly aid in weight loss. "There is a misconception that obesity surgery is cosmetic surgery. It is not," he stresses. "It's not about shape, it's about health." Many do not realise how important it is to lose weight, he says. Once you lose 30 per cent of your excess body weight, the rest of your health problems will be greatly diminished.
He also measures his success by the number of patients who turn up for the support group at the centre. "We address everything from their experience to keeping the weight off," he says. "Some patients are already automatically tuned to their big size before surgery, and even after losing weight they keep buying big clothes." The centre also conducts follow-up checks on patients.
His advice to curb obesity is to stay healthy, eat a proper diet and make time for exercise, no matter how busy you are. "We help restructure your stomach, but not your brain," he says. "You have to be determined to lose the weight and keep the weight off."


KPJ     Damansara    Specialist Hospital   was  established   in 1997 and is under the flagship of   KPJ   Healthcare   Berhad, the  largest  healthcare group in    Malaysia   and   Southeast Asia, with 21 hospitals under its wings. The hospital offers a   wide   range   of   services including health screenings, state-of-the-art-facilities, specialist care and 24-hour emergency service. It is also one of the top medical tourism hospitals promoted  by  KPJ  Healthcare.  The  hospital  has also achieved  numerous accolades,  such  as the  Malaysian  Society for Quality  in  Health  (MSQH) accreditation.
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