MANILA, Philippines—Even before the unkind words and scrutinizing looks Lani Ayala receives from people around her, the 38-year-old real estate and property leasing officer from Davao City already knew she really had to take control of her life.

Weighing 112.5 kg (248 lb), she knew she was way beyond the average that her 5’3” frame should have.

Although her health has remained fine she nevertheless decided to do something to lose weight and keep it.

“Of course I tried fad diets like South Beach, The Zone, and rotation and even played badminton as well as work out in the gym. In the end I just repeated an endless cycle of sudden weight-loss followed by equally fast weight-gain that began when I was in Grade 4, when my parents put me on a diet,” Ayala remembered.

Morbidly obese

Ayala is just one of the 600,000 Filipinos diagnosed as morbidly obese, joining the estimated 115 million others with similar diagnoses around the world who may develop or may already developed serious health problems such as diabetes, heart disease, stroke, sleep apnea, hypertension, severe knee and back pain, cancer and metabolic syndrome that may cause sudden unexplained death.

Indeed, obesity—whether its morbid or its milder form—is rapidly becoming one of the greatest health challenges of the 21st century.

“No disease is more common and causes more unnecessary illness or early death than obesity, which has recently been described as a disease in which fat has accumulated to the extent that health is impaired. In fact, as early as 1997 the World Health Organization has already declared obesity as a disease,” informed Dr. Ferdinand Ernesto Samonte of Delos Santos Medical Center and the Bib and Lap-Band Center, a pioneering institution in the country for effective weight-loss intervention.

40 and above

While obesity has three levels (using body mass index that divides the patient’s weight in kilograms by his or her height in meters squared), those who have a BMI of 30 to 34 are Type 1 Obese while those with a BMI of 35 to 39 are Type 2 Obese. Individuals who have a BMI of 40 and above are not only Type 3 Obese but also considered morbidly obese.

However, Samonte disclosed that a WHO report said Asians need not reach a BMI of 35 or 40 before they would start to develop metabolic diseases associated to obesity.

“At a BMI of 27.5, Filipinos, based on the Food and Research Institute survey, start to become high risk to develop these associated medical problems,” Samonte warned.

For patients like Ayala, the solution takes more than dieting, exercises or taking medicines.

More effective

“I once watched an American talk show that tackled drastic but more effective weight-loss options. While I got scared of the other procedures that involve stomach stapling, rerouting or cutting of the intestines, I got curious about Lap-Band, which is the safest (little or no complications) and least invasive of the surgical options featured,” Ayala reminisced.

In a recent clinical study, Lap-Band patients can effectively lose as much as 87 percent of their excess weight in two years. Half of the test subjects who underwent a medical program that included a variety of strategies such as a very-low-calorie diet (500 calories a day) with liquid meal replacements, prescription weight-loss medication and behavioral therapies had regained much of their lost weight at the end of the 2-year study.

The other half who had the Lap-Band were able to keep the lost weight off.

Pioneered

With these information Ayala searched for Samonte who pioneered the procedure here in the country (the Bib and Lap-Band Center is located at the 21st floor of the Medical Plaza Makati at the corner of Amorsolo and De La Rosa streets).

Samonte remembered that before Ayala underwent Lap-Band surgery in January 2007, she went through a series of medical examinations such as thyroid exams, psychological assessment and heart exams under cardiologist Dr. Enrique Posas to ensure that she was prepared for the surgery.

After her surgery, Ayala averaged a weight loss of 1 kg a week or 3.6 kg to 4.5 kg a month. A year after she trimmed to just 60 kg or 132 lb (she continues to lose more, she added).

“What made her surgery successful was that she was a good patient following the required diet of liquids and broth during the first month, then slowly incorporating solids like soft vegetables, chicken and fish in the following months; coming regularly for her Lap-Band adjustment schedules as well as follow-ups with me and her nutritionist,” Samonte explained.