Weight Reduction and Obesity Management Programme, Dubai

This accreditation recognises the quality of the ethical, evidence-based weight reduction programme offered by Mediclinic in Dubai, which is delivered in accordance to recognised international standards of patient care.

Through the four facilities now offer comprehensive medical and surgical services for the treatment of adults with obesity with the aim of improving health through weight management.

Our multi-disciplinary team is comprised of:

• Consultant Endocrinologists
• Consultant Bariatric Surgeons
• Bariatric Coordinator
• Gastroenterologists
• Dieticians
• Anaesthetists
• Psychologists
• Exercise Therapists

Services and benefits:

• State-of-the art evidence-based care for obese patients
• Multi-disciplinary team reviews all weight reduction cases
• Decisions are made in the patient’s best interest as per recognised international standards
• Full range of treatment modalities coordinated by our multidisciplinary team
• Members of the multidisciplinary team are readily accessible to provide advice and guidance
• Access to patient support group to promote obesity related knowledge and awareness
• Fully compliant with the American Society for Metabolic and Bariatric Surgery guidelines
• Facilitates and empowers patients to make healthy lifestyle changes

Patient criteria:

Patients must be over 18 years of age, independently mobile and attending to activities of daily living (ADLs):

For Non-surgical weight management any individual who wishes to address weight are accepted into the programme which includes an initial dietitian lead review. The Dietitian will then refer accordingly to other MDT members as required.

Patients who fit criteria for surgical weight management are offered additional visits to a Bariatric surgeon. Criteria for Bariatric surgery include:

1-Patients with BMI ≥ 35 kg/m², will be considered for bariatric surgery

2. With BMI 30-34.9 kg/m² who do not achieve sustainable or durable weight loss or with  co-morbidities e.g type 2 diabetes, hypertension, hyperlipidemia, obstructive sleep apnea (OSA), non-alcoholic steatohepatitis (NASH), non-alcoholic fatty liver disease (NAFLD), will be considered for bariatric surgery

Note: BMI thresholds is adjusted in Asian population such as BMI>25kg/m2 is considered as clinical obese.

3-Patients with BMI ≥ 27 kg/m² will be considered for pharmacotherapy, balloons and endoscopic sleeve gastroplasty.
All patients entering the program will be assessed by a Bariatric coordinator or Physician at first visit for suitability and given a management pathway.

Programme components:

Dietician and weight reduction coordinator

Your weight reduction coordinator will work as the patient’s first line of contact to:

• Organise a multidisplinary team for weight management cases to define the most suitable procedure for weight loss
• Assist clients in devising and carrying out weight-loss plan, using established dietary programs or procedures
• Interviews client to obtain information on weight development history, eating habits, medical restrictions, and nutritional objectives
• Explain programme and procedures base on the international guidelines, which should be followed to lose desired amount of weight, and answer client questions
• Follow up and monitor patient’s progress post procedure
• Coach the patients suffering from obesity to integrate mindfulness and positive behavioural related habits

Integrative Medicine:

• Provides a personalised, patient centred solution to obesity by addressing the underlying factors causing obesity
• Through motivational interviewing, the clinician first explores the relationship between inflammation, hormonal imbalance, gut health, chronic stress and sleep deprivation and resultant obesity with patients
• An individualised, unique plan is created through collaboration with the patient, focusing on:
  • Using food as medicine to improve microbiome and reduce inflammation
  • Key nutritional supplements to address micronutrient deficiency associated with obesity
  • Coaching on real life techniques to reduce stress including mindfulness based stress reduction, meditative breathing etc.
  • Tips on improving sleep
• This approach coupled with appropriate investigation and treatment options for metabolic syndrome is integral to achieve long term weight loss, and improved overall health.

Medical management

The endocrinologist will help to:

• Formulate an individualised medical investigation and therapeutic plan in collaboration with other members of the MDT
• Facilitate the use of licensed weight loss medications.
• Evaluate the clinical presence and importance of diseases associated with obesity (e.g. diabetes, dyslipidemia, hypertension, cardiac function, obstructive sleep apnea, non-alcoholic fatty liver disease etc.) and their optimal management
• Assess cardiovascular risk factors, including obstructive sleep apnea and other potential health problems, and ensure they are addressed preoperatively and postoperatively if bariatric surgery is contemplated
• Monitor for nutritional deficiencies (vitamin D and folic acid) preoperatively, 3–6 months postoperatively, and annually thereafter or as needed

The bariatric surgeon will:

• Possess advanced bariatric and laparoscopic skills
• Assess the individual patient’s suitability for surgery taking into account factors such as age, co-morbidities and previous medical and surgical history
• Provide clear explanation on benefits, risks and common complications of surgical procedures to enable patients give informed consent. The recent NCEPOD report recommended that ‘As for all elective surgery, a deferred two-stage consent process with sufficient time lapse should be utilised, and details of benefits and risks should be clearly described, and supported with written information’
• Provide patients the likely weight reduction outcomes after different surgical procedures and emphasise the need for long-term lifestyle changes and follow-up postoperatively
• Advise and support the patients in choosing appropriate bariatric surgical procedure

The gastroenterologist will:

• Play an important role in preoperative assessment and postoperative management. Gastroenterologists are one of the integral members of the multi-disciplinary teams
• Assess and deal with common complications of surgery related to GI tract structure, function, and mucosal integrity procedures
• Assess and treat nutritional deficiencies (vitamin B12, folate, zinc and anaemia) in collaboration with dietician
• Help optimise care of the bariatric patient and set the stage for effective development, testing, and use of the many new endoscopic, intraluminal, and pharmacological GI-based therapies for obesity that are under development

The psychologist/psychiatrist will:

• Evaluate patients before bariatric surgery if mental health issues identified during initial evaluation
• Provide pre-operative evaluation where needed enabling identification of interventions that can enhance long-term compliance and weight maintenance
• Provide psychological support if eating or binge disorders identified as it increases risk of and lower weight loss and weight regain after some bariatric procedures

Exercise therapist will:

• Assist in patient’s recovery post-surgery
• Assess and coach  patients suffering from obesity and prescribe workout regimen 

What to do next? Please contact one of our Weight Management Coordinators or the Contact Centre on 800 1999 for more information or to book an appointment.

Contacts:

Mediclinic City Hospital: Sreela Nair,  City.weightreduction@mediclinic.ae  
Mediclinic Parkview Hospital: Mona Joumaa, MPAR.weightreduction@mediclinic.ae
Mediclinic Welcare Hospital: Amera Varghese, MWEL.weightreduction@mediclinic.ae
Mediclinic Dubai Mall: Amal Al Rifai, MDUM.weightreduction@mediclinic.ae