This is according to surgeon Dr Gary Fetter, who has done hundreds of bariatic surgeries on morbidly obese patients who cannot lose weight any other way and suffer from a host of life-threatening diseases.

Bariatic surgery refers to operations to make obese people’s stomachs smaller so that they can only eat a limited amount. This includes gastric bypasses and Biliary Pancreatic Diversion (BPD).

“Patients can expect to lose between 12 and 20kgs with a few months of having this operation,” said Fetter shortly after performing a gastric bypass on a 138kg diabetic man at the N1 City Hospital in Cape Town.

“But I didn’t get into bariatic surgery to make fat people thin,” he told Health-e News. “People tend to see obesity surgery as cosmetic, but it is not. It is a method to cure a range of diseases instead of trying to control them with medicine, which gets more difficult and more expensive as these diseases progress.”

Bariatic surgery costs around R150 000, but this cost is recovered within four years through savings on medicine and other interventions needed to control obesity’s deadly co-morbidities, according to Dr Andre Potgieter, vice-chairperson of the SA Society for the Study of Obesity and Metabolism (SASSO).

The surgeons were hosting a workshop on bariatic surgery ahead of an international conference of colon and rectal surgeons in Cape Town, and SASSO used the opportunity to ask whether South Africa’s public health sector could continue to ignore bariatic surgery.

South Africans ranked as continent’s heavy weights[quote float=”right”]”People tend to see obesity surgery as cosmetic, but it is not. It is a method to cure a range of diseases”

South Africans are the fattest people in Africa, and obesity is a growing problem.

“The average weight of adolescent girls has increased by 10kg since 1985,” according to Professor Tessa van der Merwe, SASSO’s chairperson. “Some 28 percent of South African teenage girls are obese, with half of all women and a third of men have a BMI over 25.”

A body-mass Index (BMI) of 19 to 25 is considered normal, and a person with a BMI of 30 and above is eligible for surgery,

Bariatic surgery is new in South Africa, with some 2 800 surgeries having been performed in the country since 2007. Only three percent of these experienced surgical complications, said Van der Merwe, an outcome on a par with the best in the world.

Patients are carefully screened by a team including a psychologist and a psychiatrist to ensure that are suitable for the operation.

“If a person’s whole life is geared to food –  and preparing and eating food – that person will not be suitable for the operation,” Potgieter told Health-e News.

However, Van der Merwe stressed that obesity was not the result of “lack of willpower”, but was caused by a complicated interplay of genetic and environmental factors.

Tv presenter Dr Victor Ramathesele said policy makers needed to be engaged to make bariatic surgery possible to patients in the public sector, “otherwise only a select few will benefit”.

An edited version of this story also appeared in the 9 September editions of the Pretoria News and the Daily News newspapers.