Mumbai: In 2011, when Zoya Khan was just 11 months old, she weighed 19 kg, a result of Monogenic Syndrome, a genetic abnormality. She underwent a sleeve gastrectomy procedure — commonly called stomach stapling — the youngest-ever patient to have bariatric surgery, according to the Limca Book of Records. Now a chirpy toddler (she turned six on December 3), Zoya weighs 30 kg, still overweight as compared to children her age. If not for the surgery, her parents Yusuf and Tajkhatun say, she would not have been alive today. They are not romanticising the issue: they lost their first son Faizan to the same disorder. He was 18 months old and weighed 22 kg.
Zoya weighed three kg at birth, but her condition, one of several genetic abnormalities identified by scientists, caused her to quickly put on a lot of weight. Dr. Sanjay Borude, her surgeon, says, “Her single gene abnormality was leading to excess secretion of ghrelin, a hunger inducing-hormone. In a day she used to take as many as 16 breast feeds plus top feeds.” The stomach consists of three parts: the fundus, the body and the antrum; the surgery removed 90 per cent of the fundus and body. “The fundus is responsible for ghrelin secretion,” Dr. Borude says. “Post-surgery, her hunger was controlled. The food also reaches the lower intestine faster.” He says that Zoya is now on high-nutrient diet and he has warned her parents against feeding her any junk food, or excess oil and sugar. He is positive that with increased movement, her metabolism will speed up and help maintain her weight.
“Zoya has improved tremendously,” her mother says. “Earlier she caught infections every now and then and had breathing difficulties which cleared gradually after her surgery. She can now stand with support. But walking is still difficult. If she tries to walk, she sprains her leg. But she goes to a BMC balwadi and plays while sitting. Earlier she only lay down and there was very little movement.” Ms. Khan who works as a maid, and her husband who is a vendor in Bandra West, where they live, now also have another child, eight-month-old sister Zara; she does not have the gene abnormality.
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Bariatric surgery in the news
When Dr. Borude operated on Zoya, some bariatric surgeons criticised his operating on such a young child. A similar debate is now rippling through the medical fraternity about Eman Ahmed Abd El Aty, and now Dr. Borude is one of the critics: “I feel that the patient should be optimised in her home town. After getting a fair idea on whether is she operable, she can be flown here.”
Ms. Abd El Aty has not stepped out of her home for more than 25 years. She reportedly weighs 500 kg, which would make the 36-year-old Cairo resident the world’s heaviest woman by a long margin. Ms. Abd El Aty’s family, believing that bariatric surgery was the only way for her to have a normal life, contacted Mumbai surgeon Dr. Muffazal Lakdawala, who has done many such procedures.
Dr. Lakdawala, known for having performed bariatric surgery on, among others, Union ministers Nitin Gadkari and Venkaiah Naidu, agreed to take the case, but wanted to operate in Mumbai. “There will be lot of pre-operative and post-operative preparation in this case for which I need my team and set up,” Dr. Lakdawala told The Hindu . But the plan immediately faced a hitch: since Ms. Abd El Aty is not able to step out of her house, her medical visa was rejected. Then, on December 5, Dr. Lakdawala tweeted to External Affairs Minister Sushma Swaraj: “Ma'am, Eman Ahmed (Egypt) 500kgs requested me 2 save her pls help me get her a medical visa as refused thru normal process.” Within a day, the visa was granted, and preparations are now underway to bring the lady to the city via a chartered aircraft.
