Kuwait second most obese country worldwide, according to study

The Elipse liquid filled intragastric balloon

KUWAIT: Kuwait is ranked first in the Arab world and second globally as the most obese country, with 80 percent of adults and 30 of children diagnosed as obese, according to a study by Kuwait Obesity Association. The increase of obesity in the world, which is classified as an 'epidemic' by global health organizations, has led to the discovery of new techniques to reduce the spread of obesity, starting from the traditional operations, sleeve gastrectomy surgery and to intragastric balloons.

The intragastric balloons are a means of helping to lose weight and scientifically proven to treat obesity and substitute for surgeries that may have some complications. Kuwait News Agency (KUNA) has taken the opinions of specialists in obesity surgery to identify the types of balloons in Kuwait, which is more appropriate compared to other operations, especially after the US Food and Drug Administration (FDA) report on the death of five people due to complications caused by some types of balloons. Spokesman of the Ministry of Health, Dr Ahmad Al-Shatti, said that the ministry is keen to take the FDA reports into account and issuing a note to follow up on patients after the balloons or sleeve gastrectomy surgery.

Shatti stressed the ministry's efforts to assume Kuwait as a regional center for prevention of chronic diseases, including conducting health surveys for the early detection of diseases and monitoring many programs to combat the disease. The Ministry is following modern medical techniques, Shatti said, adding that there are many types of balloons, but the approved for liquid filled balloons are five (Orbera, ReShape, Spatz and Elipse), including the gas-filled balloon (Obalon). Each have advantages and disadvantages.

Healthy eating and exercise

Dr Mohammad Al-Jarallah, a former Minister of Health and a consultant surgeon specializing in obesity surgery, said healthy eating and exercise, in addition to weight management surgeries, are considered the best solutions for obesity. "Elipse and Obalon are considered of the best balloons, where Elpise does not require any anesthesia and weight 700 grams, while the second is light on the stomach (three grams) and the patient needs three balloons to achieve the goal," Jarallah said. Diabetic obese patients' should use balloons in connection with the reduction of blood sugar, while the morbidly obese should go for sleeve gastrectomy surgery as a guaranteed treatment for blood sugar and blood pressure, he added.

Dr Khaled Al-Zamel, Specialist of General Digestive and Bariatric Surgery at Amiri Hospital, said liquid balloons are placed in patient's stomach after anesthesia, then filled with saline, while the gas balloons are swallowed orally through a capsule without anesthesia, and then filled with nitrogen gas. Removing it needs an endoscope with local anesthesia.

The liquid-filled balloons stay in the patient stomach from four months to a year, while the gas-filled balloons could stay for six months, Zamel pointed out, as leaving the balloon longer or fill it more will cause health complications. Zamel warned obesity patients who had already done the laparoscopic gastric banding or the sleeve gastrectomy surgery of also having the balloons, as such step would be "dangerous".

Acute pancreatitis

Head of Kuwait Obesity Association Dr Youssef Buabbas said acute pancreatitis is a complication caused by the liquid balloons, where after filling it with 900 ml of saline, they will add a pressure on the pancreas, and because they are made of silicone and placed at the bottom of the stomach, it would gather bacteria. Meanwhile, the gas-filled balloon does not interact with the enzymes and does not settle in the stomach for its lightweight, he noted. - KUNA