April 11, 2022
As new research reveals, weight management is not just a matter of willpower. Metabolic diseases like type II diabetes and obesity are finally getting the medical intervention it deserves.
Type II Diabetes and obesity are major health epidemics that we face in South Africa and unfortunately, is often underappreciated for its impact on our country’s health system. Dr. Ryan Ramdass is a specialist physician with interests in diabetes and infectious disease at Busamed Gateway Private Hospital in uMhlanga. He says weight management is not merely a matter of willpower. “Metabolic diseases like type II diabetes and obesity are finally getting the medical intervention it deserves.”
Dr. Ramdass says metabolic diseases are continuously evolving which makes the strides he’s seeing in his practice particularly important. “With the advent of new therapeutic aids, medications and surgical interventions are fast becoming more accessible to the general public and we want to see greater access still to these innovations for the communities around us.”
In the sphere of Diabetes, for example, some treatment advances include fixed-dose insulin combinations. “This offers patients additional benefits in terms of weight loss which is a target goal for type II diabetes.” He says this class of treatment is showing impressive results on cardiovascular and renoprotective benefits.
In the sphere of obesity, metabolic surgery (otherwise known as bariatric surgery) is becoming more and more available. “We’re trying to make those more socially accepted. Certainly, these surgeries address other health issues such as hypertension and can ameliorate diabetes, as well.
“In South Africa, we have medical options that include two registered drugs for primary obesity. In the past there were very limited options and again, we’re trying to access to these medications to patients who meet the requirements and get society to understand that obesity is not cosmetic but that it is in fact, a disease that has great impact on survival and quality of life.”
Dr. Ramdass says obesity is a condition that is preferably discussed with younger patients so that there is a better outcome for the patient. He adds that when a metabolic disease is addressed medically or surgically, there must be follow-up assessments that help the patient manage their repaired metabolic system.
“There is no point in having an intervention without having a goal. And the intervention still requires the patient’s participation after the treatment has been administered. This is where risk factors are taken into consideration and where a good physician will turn to in helping to maintain the results post treatment.”
Dr. Ramdass says it’s true that patients don’t always comprehend what their risk factors are and there isn’t always adequate education given by physicians to explain what the trigger points are. “Patients might not always know how to look for their risk factors or even assess the impact of what their risk factors can do to add to the burden of disease. That’s where we, as physicians, should be investigating non-modifiable factors (like genetics) and modifiable factors (like lifestyle).”
Dr. Ramdass says a patient has a better rate of success in treating their metabolic disease by adopting a total audit of their risk factors and complications and working on carving out a path that is more sustainable over time.
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