Agnes Kariuki had just given birth to her third child and was struggling to shed off the post-baby weight.
She was known among her friends for her small frame, which was slowly becoming a mirage. The kilos kept piling on and the once 54-kilogramme girl was now at 90 kilogrammes. Comments on how successful her life had become after marriage were soon followed by concern about the drastic weight gain.
“When I realised I had grown from 54kg to 90kg, I felt I had to do something. My friends, too, noticed how much weight I had gained,” says Ms Kariuki.
The five years that followed were spent exploring every weight loss method she could read about.
“I was looking for a permanent solution. I tried the gym and even tried weight loss pills but none was helping. I came to learn about a procedure known as gastric band through a friend who works at the Nairobi Hospital,” she says.
After researching about the procedure, Ms Kariuki booked an appointment with Limohouse Clinic and two days later made up her mind to have the surgery.
“I did a test at Limohouse Clinic where the procedure was being done and samples were sent to Nairobi Hospital to ascertain whether I was eligible for the procedure,” she says.
At the clinic, Ms Kariuki met Vladmir Shchukin, a bariatric surgeon, who took her through the procedure.
Bariatric (weight loss) surgery includes a variety of procedures. Weight loss is achieved by reducing the size of the stomach with a gastric band or through removal of a portion of the stomach (sleeve gastrectomy) or by resecting and rerouting the small intestines to a small stomach pouch (gastric bypass).
“In my experience in this field, bypass is the most complicated surgery. It is done on the most serious obese, class 4-5 obesity,” says Dr Shchukin.
Gastric bypass patients are more likely to be suffering from metabolic syndrome and hence it is more effective in correcting diabetes in those who are grossly obese.
“The patient may suffer from lack of certain minerals and vitamins as a result of the surgery. Normally they are advised to have a corrective therapy once or twice a year to make sure the minerals and vitamins balance are back together,” the surgeon explains.
In the West, the procedure is known as a quick fix because patients automatically lose weight regardless of their eating habits.
Dr Shchukin offers surgical and non-surgical weight loss treatments. Procedures done include insertion of a gastric band, gastric sleeve resection and bypass.
He adds that the bypass is the most complicated because it is irreversible and can also cause complications that can lead to high hospital bills or at worst, death.
The procedure leads to changes in the physiological and psychological response to food such that when a patient ingests a small portion of food, the wall of the stomach stimulates nerves signalling the brain that the stomach is full.
With sleeve gastrectomy, more than half of the stomach is removed, leaving behind a thin vertical sleeve. It has a high success rate and low incidence of complications but is not reversible.
Ms Kariuki went through an adjustable gastric band where an inflatable silicone device is positioned in the upper part of the stomach, creating a small pocket to hold food. It restricts the amount of food one can eat by creating a filling of fullness after eating just a small amount. It can be adjusted to restrict or allow more food.
“Ninety nine per cent of bariatric surgeries at the clinic have been successful, with most patients going for the laparoscopic adjustable gastric band,” says Dr Shchukin.
The gastric band does not involve bypass of the bowel hence does not interfere with food absorption. Thus, there is a lower risk of vitamin and mineral deficiency.
Gastric banding is considered the least invasive weight loss surgery and the safest. The procedure can be reversed, and in time, the stomach returns to its normal size.
Ms Kariuki reveals that after having the band for four months, the normally recommended duration, she lost 21 kilogrammes.
However, she warns this should not be taken as a substitute to other weight loss regimes such as exercise because you have to maintain the weight loss.
Dr Shchukin says gastric ballon in Kenya costs Sh350,000 while in Europe the cost is Sh600,000-Sh700,000. A gastric sleeve costs Sh850,000 while a bypass costs around Sh1 million.
Based on the World Health Organisation, obesity is the fifth leading risk of global deaths, with 2.8 million adults dying each year from weight-related conditions.
In addition, the WHO notes that a large percentage of diabetes, heart disease and cancer burdens are attributable to being overweight.
Diabetes affects 3.5 million Kenyans and diabetes medicines sold in Kenya this year were valued at Sh2.5 billion while those for hypertension cost patients Sh2 billion. billion this year.