The fattest former man in the world is doing well. But he still has some way to go before he can leave his hospital room and walk again. However, it illustrates the “miracles” that obesity surgery does.
A few years ago, Juan Pedro Franco held a sad record: that of the fattest man in the world. At the time, he weighed almost 600 kilograms – 595 to be exact. Suffering from diabetes, a poor thyroid function, hypertension and severe pulmonary obstruction, the 31-year-old man decided to travel to western Mexico, to Guadalajara, for treatment in the clinic Gastric Bypass Mexico, an establishment specializing in the treatment of obesity.
In May 2017, the man followed a draconian diet before undergoing surgery by gastric bypass surgery, a surgical method that shrinks the stomach by creating a bypass in the digestive tract to decrease absorption of food through the small intestine. The new diet and the procedures performed by the surgeon José Antonio Castañeda allowed Juan Pedro to lose around 250 kg. Doctors hope to be able to reduce the weight of this young Mexican to 100 kg.
” I am very happy because everything is fine ”
Today, Juan Pedro even manages to take a few steps, using a special walker to help him support his body weight. The device is also equipped with accessories allowing him to perform daily physical exercises. ” Every day, he exercises more, he tries to get up, to get out of it, he has a very positive attitude, ”Dr Castañeda told AFP. Juan Pedro’s dream is simple: “to walk again” and reconnect with guitar and singing, his two passions.
But the road is still long for the Mexican: “everything will depend on his evolution and the treatment of his lymphoedemas in the legs”, estimates the interdisciplinary medical team of the clinic Gastric Bypass Mexico. “He is a complex patient and at risk, until his extreme obesity ceases. We are trying to save a life and we will remain vigilant until it is out of danger, ”explain the caregivers. Juan Pedro, for his part, is optimistic: “I am very happy because everything is going well,” he told AFP.
Before his operation, Juan Pedro’s situation was very critical. Obesity promotes diabetes, and blood lipid disorders, which increase the risk of vascular (stroke) and heart, or kidney failure. In cases as extreme as that of this young Mexican, all these risks accumulate. The risks of infection are also to be taken into account. The young man, totally sedentary because of his weight, was at risk of developing infectious bedsores.
The illustration of obesity surgery
With nearly 60,000 interventions carried out in 2016, France is, in volume, the second country in the world, far behind the United States, where several hundreds of thousands of interventions are carried out each year. The example of certain personalities, like Juan Pedro but also the footballer Diego Maradona or some famous actors, has done much more for the popularity of this surgery than all the medical congresses in the world, but be careful, however, we must moderate the enthusiasm. , this surgery is only designed for people with severe obesity, which is easy to verify.
In France, the number of people who have taken the plunge rose from 2,800 in 1997 to 59,300 in 2016. 80% of women; between 25 and 54 years old.
It is also called – you will often read this incomprehensible name – weight loss surgery. She had, for a long time, a very bad reputation, especially among doctors, drawing her sulphurous image from her practice in questionable pharmacies and from some serious accidents during or after the operation. Opinion has changed, due to the growing number of dramatic obesities that cannot be reduced, which are known to be life-threatening; and above all the excellent results very quickly. The letters of nobility have arrived with his practice in cutting-edge digestive surgery departments.
The technique has also evolved.
There are several types of intervention, quite simple, but which remain true acts of surgery, to prevent excessive food intake. All of them are the result of the most elementary logic.
The first performed consisted in reducing the capacity of the stomach, by about a third, by placing a “gastric ring”, to accelerate the feeling of “filling”. The ring is connected to a fixed capsule located under the skin, which allows the size of the narrowing to be adjusted. This technique is less and less practiced today (less than 4% in 2016 according to the study against 54% ten years earlier.
It will disappear in favor of an intervention which consists in removing two thirds of the stomach and making, with the rest, a sort of tube.
Finally there is a technique, difficult to achieve compared to others, but the results of which are even more spectacular and which is reserved for very obese people. It consists in carrying out an intestinal bypass, a “by pass”, which means that we bypass the assimilation of certain foods in the intestine by accelerating their circulation.
These procedures are done from a simple small hole, last 1 to 3 hours, and under general anesthesia.
The results are spectacular … but at the cost of some inconvenience
Weight loss can be up to 40%, but complications are quite common. We mention the figure of 10%, most of them related to anesthesia, because it remains a not insignificant surgical act. In addition, long-term monitoring, throughout life, to take into account the deficiencies, especially in vitamins, that this too rapid digestion causes.
However, the legitimacy is no longer discussed today in cases of severe obesity and this surgery, initially conceived as a simple modification modulating the intake or absorption of calories, also leads to a spectacular improvement in the secretion of certain hormones. It therefore produces unexpected beneficial effects at the start and well beyond weight loss.
Treatment for diabetes?
For example in diabetes, where more than 80% of patients are overweight, and more than a third are obese. Of these, despite conventional medical treatment, half die of heart disease and about 1⁄4 of stroke, reflecting the level of drug failure. One of the world’s best specialists, Professor Philip SCHAUER, from Cleveland in the United States, speaks of a real paradigm shift: “For more than a century, the treatment of diabetes in obese people has been through tablets and injections. We have just shown indisputably that this surgery can be much more useful“. Immediate translation, mortality decreases by 92% and in 81% of cases and this diabetes disappears in less than 2 years
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