It's a huge weight off their tummies
Family members who lose more than 30kg each after gastric surgery say they have fewer health worries
The family of three were weighed down by their obesity.
Their combined weight: 385kg.
At 125kg, Mr Samat Said, 65, suffered from arthritis, diabetes and hypertension.
His wife, Madam Salmah Ahmad, 59, was 105kg and had diabetes, hypertension and high cholesterol.
Their daughter, Miss Sakdah Samat, whose weight was 155kg, had asthma attacks and felt breathless so often she was sent to the accident and emergency department no less than five times last year.
They were issued an ultimatum by their doctors: Lose weight, or else.
Madam Salmah said: "The doctor was increasing the (medicine) dosage for my diabetes to keep it under control.
"He said that if I opted for surgery, there would be a high chance of me being free from my illnesses."
She underwent gastric bypass surgery in 2012, and her husband followed suit two months later.
Miss Sakdah, 35, who saw the success of her parents' operations, went for gastric sleeve surgery last September.
Based on their needs, these different types of surgery were recommended by Dr Jaideepraj Rao, the director of the bariatric surgery programme at Tan Tock Seng Hospital. (See report right.)
The couple put on weight after they became less active in their later years, but Miss Sakdah had weight issues her whole life.
At Primary 5, she weighed 65kg.
"I was always the biggest in school. My friends always called me 'fatty'," said Miss Sakdah, who is 1.55m tall.
After she started working as a customer service executive, strangers who saw her struggle while walking would advise her to lose weight.
"Some of them would even recommend me pills and herbs to take. They tried not to offend me by calling me 'big' instead of 'fat', but their sympathy just made me feel worse," she said.
Each time, Miss Sakdah would swallow those frustrations and ill-feelings by indulging in food.
She kept on having five full meals of rice, noodles and deep-fried food until she had to be hospitalised for her asthma attacks last year.
"The doctor told me I needed to lose weight. After seeing how my parents' diabetes, hypertension and high cholesterol disappeared after their surgery, I decided to go for it too," said Miss Sakdah, who has a younger brother.
All three qualified for subsidy because of their condition, and paid for the surgery through Medisave and Medishield.
They had to go through tests and counselling to make sure they were fit for the surgery and physically and mentally prepared for the extreme lifestyle changes ahead.
Initially, the family had difficulty matching their cravings to their appetites.
They were put on a liquid diet for two months and a purée diet for another two months before they could start eating without restrictions again.
For the first week after surgery, Madam Salmah would vomit after meals.
Mr Samat, whose breakfast staple used to be three pieces of roti prata, said he has space for only one now.
"I even offered to pay the price of two pratas when the hawker told me that was the minimum," he said.
For Miss Sakdah, who now feels full easily, it was pure agony not being able to satisfy her fast-food cravings.
"There was a period I even broke down because I was so depressed over not being able to eat," she said.
The family tries not to waste food by sharing dishes when they dine out, but realised they received dirty or sympathetic glances from other customers.
Said Madam Salmah: "When we go to restaurants, we order only a plate of pasta and a drink because we cannot finish.
"So paiseh (embarrassing in Hokkien) sometimes. People look at us like we cannot afford more food."
But those are minor gripes for the family, whose health has improved.
To date, they have each lost more than 30kg.
Mr Samat and his wife are now 92kg and 68kg respectively, and no longer have to take medication for hypertension, high cholesterol and diabetes.
Their daughter now weighs 124kg and no longer suffers from breathlessness.
Miss Sakdah clocks three hours of swimming at least four times a week and supplements that with gym sessions on weekends.
Her parents take more walks and lead more active lifestyles.
Having an easier time shopping for clothes is a bonus, said Mr Samat, who lost 10 inches on his waist.
"We used to wear dark-coloured clothes to look smaller. Now we can wear brighter colours again," he said with a laugh.
There was a period I even broke down because I was so depressed over not being able to eat.
- Miss Sakdah Samat on the difficulty in getting used to her post-surgery stomach
Common misconception that surgery is cosmetic
Not everyone who approaches him for bariatric surgery, a weight-loss surgical procedure, will be allowed to go through it, said Dr Jaideepraj Rao.
The director of the bariatric surgery programme at Tan Tock Seng Hospital said that only those with a Body Mass Index (BMI) above 32.5 are recommended the procedure.
A subsidised bariatric operation costs between $6,000 and $10,000. It can cost up to $20,000 without subsidy, the doctor said.
Dr Rao, who operated on Mr Samat and his family, said patients who are borderline obese are first put through a diet programme before surgery is considered.
"I will recommend younger patients, like Miss Sakdah, who do not have diabetes and are volume eaters, to go for sleeve gastrectomy," he said.
"Those who are slightly older and suffer from conditions like diabetes can opt for a gastric bypass."
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While more people are opting for bariatric surgery, Dr Rao is quick to debunk a common myth - that weight-loss surgery is for cosmetic purposes.
"It is actually a metabolic surgery meant to cure or treat medical conditions, but people don't have that concept," he said.
As bariatric surgery is done in a minimally invasive way nowadays, Dr Asim Shabbir notes a significant decrease in complications.
Dr Asim, a consultant at the National University Hospital's centre for obesity management and surgery, said the risk of a patient losing his life to complications is lower than many major surgeries.
The high cost of the surgery could be a deterrent, but it is a one-time expenditure, he said.
Rather than making medical problems worse, bariatric surgery improves them, Dr Asim said.
For instance, conditions like Type 2 diabetes will be in remission and there will be a significant improvement in medical problems like sleep apnoea and hypertension.
As a result, those with several medical conditions related to obesity can cut down spending on medication, Dr Asim said.