Why access to bariatric surgery in Nigeria remains critical challenge, by medical experts

Access to bariatric and metabolic surgery services emerged as a major issue at a two-day scientific conference held in Lagos under the theme, ‘Exploring the paths towards growth and prosperity for weight loss surgery in Nigeria.’

The annual event, organised by the Bariatric and Metabolic Surgeons Society of Nigeria (BMSSN), Lagos chapter brought together medical experts who examined barriers to treatment, patient outcomes and pathways to make life saving obesity care more accessible across Nigeria.

Bariatric surgery is a surgical procedure performed on the stomach or intestine to treat sever obesity. By altering the digestive system, it helps patients lose weight and manage hunger.

Speaking at the conference, President Bariatric and Metabolic Surgery Society of Nigeria, Abuchi Okaro, said that the theme of the conference was ideal as it would help bariatric surgeons in Nigeria build on their successes after I5 years of bariatric surgery in the country and get themselves ready for the future.

Okaro, a Consultant General, Upper Gastrointestinal and Bariatric Surgeon at Euracare Hospital Lagos described I5 years of bariatric surgery in Nigeria as a journey of pioneers, patients and progress.

According to him, “From a virtually non-existent service in 2010 to an emerging multidisciplinary healthcare field, stakeholders say Nigeria is gradually building a credible framework for obesity and metabolic care despite daunting financial and infrastructural challenges.

“We needed to make sure that we had alignment among key players and show proof that bariatric surgery services can actually work in Nigeria to a very high standard.

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“All our results over the last four years are independently monitored and collected data. They show clearly that the Nigerian bariatric and metabolic healthcare space is active and can stand up to international scrutiny’’.

Okaro identified access and affordability of bariatric services as major challenges facing bariatric procedure in the country.

“Surgery remains entirely out–of-pocket for most patients. The cost of consumables, anesthesia, and post-operative care places bariatric surgery out of reach for the majority who need it most.

“Every stapler cartridge, bougie, and port is imported. Customs delays, FX shortages, and distributor gaps have disrupted theater lists. This fragility is an ongoing operational risk,” he said.

Speaking on ‘Historical evolution of bariatric surgery in Nigeria’, Consultant Laparoscopic, GI and General Surgeon, Iliya Salu, described bariatric surgery as an emerging field in Nigeria that treats morbid obesity and its comorbidities, including diabetes, hypertension, and sleep apnea.

“The first metabolic surgery dates back to 1954 performed at the University of Minnesota. It was called the jejunoileal bypass and based on the theory of malabsorption, this procedure bypass most of the small intestine and was devised to treat severe dyslipidemia.

“Although weight loss following this procedure was significant, it also resulted in undesirable side effects, such as severe dehydration and diarrhea. Edward Mason introduced the first technique called bariatric surgery in the 1960s. He observed that-patients who had portion of their stomach removed to treat stomach cancer or ulcers experienced unexpected side effect of significant weight loss. He determined that the same technique could be used to encourage weight loss in obese patients.”

On her part, Consultant Endocrinologist, Nkem Okoli, said that diabetes prevalence continues to rise at an alarming rate worldwide, with obesity remaining a major driver of the disease.

She added that diabetes accounted for nearly $1 trillion in healthcare spending globally, representing about 12 percent of worldwide health expenditure.

The health practitioner expressed hope that increased awareness, stronger collaborations and improved healthcare policies would expand access to obesity treatment services across the country.

Speaking on ‘Clinical outcomes and safety data from Nigeria (2022-2024)’, Consultant Bariatric/ Laparoscopic Surgeon, Getslim Bariatric Center Abuja, Timi Adenuga observed a rise in the number of bariatric procedures done, adding that there is need for documentation on the number of bariatric procedures done by their members so as to have baseline and reference point.

According to Adenuga, the Nigeria experience validates safe bariatric scaling in developing markets.

“Rapid institutional scale-up is structurally achievable in Nigeria without compromising strict, standard-of-care morbidity or mortality thresholds.

While endoscopic options provide a high utilised, zero-stay entry point, surgical interventions deliver unequivocally superior weight loss and profound metabolic resolution.”

Speaking on, ‘Beyond the scale: The critical

role of nutritional and behavioural insight in advancing bariatric care in Nigeria’, Clinical Nutritionist Consultant, Gut health bariatric and lifestyle medicine practitioner, Sherese Ijewere, observed that obesity rates are rising globally, adding that it affects physical, emotional and social health of the patients.