Juan Pedro Franco Salas, a 32-year-old Mexican, who recently weighed 600 kg, underwent a gastric bypass. An operation to save his life.
He is the fattest living man in the world. Or at least he was. Juan Pedro Franco Salas weighed, a few months ago, 595 kg. He has since lost 175 kg, following a strict diet, in order to be able to undergo a gastric bypass. The surgery is supposed to provide him with lasting weight loss, essential to keep him alive.
It involves removing the lower part of the stomach. The remaining part is then connected directly to the small intestine, further down the digestive tract. The procedure allows both to reach the feeling of satiety more quickly, and to limit the absorption of nutrients in the first part of the intestine.
“The operation was practically a total removal,” said José Antonio Castañeda, the surgeon who operated on the 32-year-old Mexican, during a press conference. We’re waiting to see how her body responds to this change and we hope all goes well. The surgeons removed three quarters of his stomach. “We hope that in the next three months, he will lose 40 to 50% of his excess weight,” he added.
Failures of vital organs
The benefits of the operation are not limited to an aesthetic or practical gain in everyday life. Morbidly obese people suffer from many pathologies, which considerably reduce their life expectancy. A study published in 2016 in The Lancet evaluated the loss at 10 years in severely obese (BMI between 35 and 40).
“We know that obesity makes you more susceptible to myocardial infarction, explained last November to whydoctor Professor David Nocca, obesity surgeon at Montpellier University Hospital. The heart grows but the fat is stored in the muscle, including at the level of the heart. It will grow in size but lose contractile function. It’s the beginning of heart failure. »
Lung failure
Morbidly obese people also suffer from venous return problems, phlebitis, which aggravate mechanical respiratory failure. “Paradoxically, the larger the obese, the smaller the lung, adds Professor Nocca. Respiratory function is significantly reduced: there is not enough room for the lungs to expand. The fat takes up more space and the rib cage has more difficulty stretching, especially since the muscles work less well. »
Obesity also 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 Juan Salas, all these risks accumulate. The risks of infection are also to be taken into account. The young man, totally sedentary due to his weight, was at risk of developing infectious bedsores.
For all these reasons, the operation became an emergency. But the Mexican had to lose weight to undergo the operation… a lot of weight: 175 kg! To facilitate the work of surgeons, which abdominal fat can hinder, but also because anesthesia represents a significant danger.
“It remains difficult and more at risk than for someone of normal weight, explains Professor Nocca. To adapt the doses, many questions remain unanswered in 2016. Anesthesiologists-resuscitators are often at a loss to administer medication. You really have to take an interest in the pharmacology of the obese. »
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