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Problem is ‘hidden’ as many obese people stay isolated and don’t take public transport
 HE WAS 250kg and could not even keep awake while his doctor was talking to him because his size prevented proper oxygen circulation to his brain. When he saw Dr Tham Kwang Wei, director of the Weight Management Programme at the Singapore General Hospital, he could not remember his medical history because his weight had affected his memory. He had also started to smell because he was so big that he could not clean himself. This was one of the worst cases of morbid obesity that Dr Tham had seen in her five years of practice in weight loss management, she told The New Paper on Sunday. Dr Tham’s patient had a BMI of 77. A healthy adult has a BMI of between 18.5 and 22.9.
Last month, the Health Promotion Board (HPB) revealed that obesity in Singapore has increased to 10.8 per cent, up from 6.9 per cent in 2004. Such figures do not surprise doctors because of Singaporeans’ love for eating. . “If you go to the basement of any shopping centre, you’ll find many shops, like a Japanese-derived concept store selling just a small bun that’s packed with fructose,” said Dr Tham.
With such concept stores and fast-food like burgers and fried chicken readily available, it is no surprise that Singapore’s obesity rate has gone up, said Dr Kevin Teh, medical director of Singapore Lipo, Body and Face Centre. While it’s uncommon to come across someone with a BMI of more than 32 on the streets here, Dr Tham said that it doesn’t mean there are no such cases. .
“Just because you don’t see them, it doesn’t mean that they do not exist,” she said. “Unlike us, they don’t take public transport because they feel uncomfortable when they take up two seats instead of one.” Her sentiments are echoed by Dr Teh, who said that such individuals isolate themselves because of poor self-image. “They are unable to integrate themselves or even function in modern society doing basic things so they choose to stay at home, away from the public,” he said.
It becomes a vicious circle: Because these people end up lonely and with nothing to do at home, they turn to comfort foods like ice cream and chocolate, which cause them to put on more weight, Dr Teh said. Morbid obesity may not always be due to a genetic disorder. Binge eating, depression and other illnesses could also lead to people putting on extreme weight. “Often obesity may be a symptom of a larger problem like a thyroid dysfunction, which may cause a person to put on a lot of weight. “It is unfair to treat a fat person as just a fat person,” he said.
At Dr Teh’s clinic, patients are assessed to find the underlying cause of their obesity before a treatment plan is presented. He specialises in liposelection, an advance form of liposuction which involves shaping of the body by dissolving excess fats in the body such as love handles. “Patients are usually advised to lose weight through diet and exercise first before they can proceed with liposculpting,” he said. However, diet and exercise may not be the best option for individuals whose BMI is above 32, said Associate Professor Jimmy So, director of the Centre for Obesity Management and Surgery at National University Hospital.
For them, bariatric surgery may prove to be the best way to beat the bulge. This usually involves modifying the digestive tracts of patients, allowing them to lose as much as 60 per cent of their weight.
However, such extreme methods are only offered to patients as a last resort after other options have been exhausted, said Associate Prof So. While such surgeries may suggest an “easy” solution to the problem of morbid obesity, only half the battle is won. The other half involves ensuring that the individual stays disciplined by exercising and eating healthily to maintain their weight loss.
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