Graham Anderson, Principal Officer at Profmed.
A recent report conducted by global pharmaceutical company GlaxoSmithKline revealed that ‘South Africa is the third fattest nation in the world’ with seven out of 10 women and four out of 10 men in SA having significantly more body fat than what is deemed healthy. These people are not only more at risk of a number of serious illnesses but may also be subject to higher insurance premiums.
According to Graham Anderson, Principal Officer at Profmed, the medical scheme that caters exclusively for graduate professionals, obesity is not just a South African problem but is increasingly becoming a global phenomenon. “Many of those most seriously at risk do not even consider the harm they are doing to themselves. The same report also indicated that 78% of obese and 52% of morbidly obese people in South Africa consider themselves to be healthy.”
“As a result, many of these people are probably unaware that their weight is not only costing them more in their insurance but that it also contributes to a greater chance of chronic conditions such as cardiovascular disease, hypertension and diabetes.”
“Obese patients may also be putting themselves at greater risk when having any form of surgery. Medical schemes use a clinical protocol known as ‘fit for surgery’ to ensure the patient faces the least risk in terms of the procedure they will undergo. If the patient is not physically ready for surgery, then the risk of complications becomes exponentially higher.”
“Obesity is one such co-morbidity – a condition that coexists with a primary disease – that may result in an increase in the level of treatment required, as well as a longer stay in hospital or complications during surgery. Whereas post-operatively the patient might have stayed in hospital for 24 hours before being discharged; a patient who is seriously obese runs the risk of collapsing during surgery, requiring a number of additional drugs and even being placed on a ventilator.”
Anderson says whether or not a patient is ‘fit for surgery’ is, however, not simply a matter of their weight. “There are a number of co-morbidities that affect whether a patient is ready for surgery, of which weight is just one. Excessive drinking or smoking, uncontrolled diabetes or asthma and high cholesterol, are all co-morbidities that can have a significantly detrimental effect on a patient during surgery.”
“It is critical for any patient who has an uncontrolled co-morbidity such as obesity to get it under control before proceeding with an operation, particularly if the surgery is elective rather than an emergency. For example, this may mean losing some weight or taking a few weeks to get their asthma to a more manageable level; but this could be the difference between a success and failure.”
“If an obese patient has a surgery turned down by their medical scheme they should first engage with the provider to ascertain the reasons behind the decision. It is in the interest of medical schemes to ensure that their members are fit and healthy, including having surgery when necessary, and the scheme may be willing to assist the member to see a health specialist to help them get their weight under control,” concludes Anderson.
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