• Dr. Muffazzal
  Lakdawala is a famous bariatric surgeon who has treated many celebrities in
  India
• Eman Ahmed is a
  500 kg Egyptian woman who has a rare LEPR mutation that triggered her
  weight gain.
• Dr. Muffazal
  Lakdiwala spoke to Medindia about treating Eman and the
  obesity levels in India

Eman Ahmed,
weighing 500 kg, was one of the
heaviest women in the world and she arrived in India in February to undergo a
bariatric surgery that would help her lose weight rapidly. Thirty
six year old Eman,
from Alexandria in Egypt, had to travel by a special cargo plane to reach
India. There was a fully equipped truck waiting for her at the airport, along
with an ambulance and a police patrol car, to escort her to a specially built
room at Saifee Hospital, Mumbai. She was lifted with the help of a crane, along
with the bed that she was lying on while traveling.

Eman Ahmed’s Condition:

Eman Ahmed is believed to be suffering
from an LEPR mutation that lowers feeling of satiety or fullness after a meal.
So she continues to eat.

• Eman weighed 5kg
  at birth and was said to have been diagnosed with elephantiasis. However,
  Dr. Muffazal Lakdawala, who is treating her, says that it could have been
  obesity related lymphedema
  which resulted in the swelling of legs and an inability to walk.
• When Eman was 11 years old, she developed a
  stroke that left her bed ridden
• Eman was weighed
  on an industrial scale just before she left Alexandria and she had weighed
  498 kgs.
• She is wider than
  she is tall. She was 151cms
  wide and 141cms tall.
• She has not been
  able to crawl for more than 3 years.

How Will Bariatric Surgery Help Eman?

A
well-known weight loss surgery called bariatric surgery was used as a last
resort to treat Eman who was dangerously obese. There are two types of this
surgical method

• Gastric bypass:
  In this type of surgery, the digestive system is connected past a
  considerable portion of the stomach, to make the body feel full with lower
  amount of food.
• Gastric band:
  In this type of bariatric surgery, a band is used to lower stomach size so
  that a smaller quantity of food would make the body feel full.

Chairperson
of The Institute of Minimal Asurgical Sciences and Research C, Saifee Hospital’s
leading bariatric surgeon, Dr Muffazal
Lakdawala, spoke to Medindia exclusively about treating Eman.

‘Dr. Lakdiwala recommends genetic test for overweight children which would help provide necessary care from childhood.’

Dr.
Lakdawala is an obesity surgeon and
an expert in Laparoscopy. Some of
the famous personalities treated by this doctor include BJP President Nitin
Gadkari, State Cabinet Minister Nitin Raut,
NCP’s Nawab Malik, Venkaiah Naidu and film actor Salman Khan’s mother.

Q.How did you become an obesity surgeon?

Ans.
In 2003-2004 I joined Johnson and Johnson, India and they were training people
to become a laparoscopic surgeon. There was very little awareness about this
condition and most doctors felt that there was too much of risk involved.
Moreover, they felt there would not be enough patients, I felt that this was a
new and exciting field and I had nothing to lose. That was the start, after which
this field has grown tremendously.

Ans. I can state that in the number of patients
who visit the clinic. 18% of children are overweight with 6% obese, 2% of the
adult population is obese. India ranks 3^rd in obesity.

Q.What is the reason behind the high obesity
figures in our country?

Ans. We
have a high genetic predisposition for obesity, combined with unhealthy
lifestyle factors. We take the worst from the Western culture and eat a lot of
fast food. Even Indian fast food is very unhealthy. Sugar is the biggest enemy
for obesity.

Q.How did you get to meet Eman and why did
you decide to help her?

Ans. Eman
is looked after by her mother and sister, she has been heavy since her
childhood. She suffered a stroke when she was 11 years old that affected her
mobility. They have been trying to reach out to doctors from across the world, but did not meet with any success. They posted their request across
various social media channels but they did not receive any help. A friend of
mine saw one of their posts and sent them a letter stating that there was a
doctor in India who is trained to help with such conditions. They got in touch
with me and I went and met them.

Q.Your move to treat Eman has reached
international fame. Your comments on that.

Ans. It
has reached international fame because of her sensational weight- 500kgs. She couldn’t even move
her neck and it has affected the quality of her life. She is 36 years old and
for the past 25 years, she has been bedridden. Due to the lack of movement, her
legs below the knees are not well developed. She can’t speak and could sip
liquids. When I met her at the hospital in Alexandria, she was fed lying down,
I was worried that she would aspirate any minute.

The
media glare has made it difficult to treat her. However, it has been utilized
to gain a cloud fund to treat her.
People have provided from 500 to 1000 rupees to even lakhs. Our hospital,
as well, has helped her financially.

Q.What is the medical support that you
provided her with?

Ans.
She weighed 498 kg before she reached Mumbai. Initially her creatine levels
were 6.5 with 37% oxygen saturation and there was a failure of the right side of
the heart that led to fluid accumulation. After we drained her fluid, she lost
weight and reached 380-390 kg. We
consulted with experts from Melbourne, Cambridge and Harvard and performed the
bariatric surgery. Post-surgery, her weight has dropped to 250 kg, her heart condition is controlled, her thyroid is normal
and creatine levels are also normal. Fluid accumulation has also been lowered.

Q.What is your goal weight for Emam?

Ans. My
goal was to make her sit up and indicate if she wanted to pass urine or stool,
which she is able to do now. She is currently 173 kg, further to this, she
requires neurological support and speech therapy. We have done our part in the
obesity clinic, a neurological clinic can take up the next part of the
challenge. Her sister wants us to make her walk, however
this is not possible, we want to send her back but her sister
does not want to take her back.

Q.What is the reason behind Eman gaining so
much weight?

Ans. Eman
has a rare mutation in the LEPR gene,
for which we need an MC4R agonist
that is currently unavailable. I recommend that young children who are
overweight should be made to undertake genetic tests to determine if they carry
this mutation so that the right care and support may be provided.