compared to normal weight people,” he said. Obesity being the mother of all diseases in fat persons, this procedure could have life-saving implications for many people in Pakistan.
Dr. Aatif maintained that while obesity is traditionally being treated with dietary changes, exercise, and weight loss medicines, remarkable weight loss is seen in patients who add surgery to the above-mentioned interventions.
Responding to a query, Dr. Aatif clarified that obesity is not just defined on the basis of weight but on BMI, which is calculated by dividing weight into kilograms, divided by height in meter squares. “Surgery is offered to patients who have a BMI of more than 40 and have failed or not responded to medical treatment, or where no other treatable cause of obesity is found,” he shared.
The surgeon added that if a patient has diabetes, hypertension or other diseases associated with obesity, then the cut-off value is a BMI of 35. “Recently, for South Asians, this value has been revised as they have more body fat ratio then western races. South Asians also have greater preponderance to heart attacks than Americans and Europeans,” he informed.
Asked about his vision for improvement of laparoscopic surgery at PIMS, Dr. Aatif said he would like to establish a Laparoscopic Surgery Centre par excellence at the Shaheed Zulfiqar Ali Bhutto Medical University-PIMS. Dr. Aatif is actively involved in training of young doctors and is imparting his laparoscopic expertise with great passion. His father Dr. Inam-Ul-Haq Shami was also an eminent surgeon of Islamabad. In 2009, he became the first surgeon to perform laparoscopic surgery in pregnant patients at PIMS. Videos of laparoscopic procedures done by him are also available on YouTube and other websites and have been viewed by thousands all over the world.
A state-of-the-art centre for bariatric surgery at PIMS will cost no more than Rs20 to 30 million. The amount is rather insignificant when compared to the billions of rupees that were squandered at the time of the establishment of an unsuccessful liver transplant centre at PIMS. A little support from the government can also lead to a decline in the cost of the procedure, which is currently in the range of Rs250,000 because of the expensive equipment that has to be procured for the procedure.
The first bariatric surgery at PIMS was performed amidst a host of challenges including, for instance, the lack of a wide enough bed to accommodate the obese patient. Appropriate gear for the patient was also not available, and eventually had to be stitched by his wife. In fact, had it not been for the personal initiative of Dr. Aatif and his team, the surgery would not have been possible.