Nigeria Leads West Africa In Bariatric Surgery As Experts Meet In Accra

Nigeria has taken a leadng role in West Africa’s response to the growing obesity epidemic, as experts in bariatric surgery convened in Accra for a landmark session at the 66th Scientific Conference of the West African College of Surgeons (WACS). The half‑day meeting, organized by the Bariatric and Metabolic Surgeons Society of Nigeria (BMS‑ SN), marked the first sub‑regional gathering dedicated to bariatric and metabolic surgery (BMS), a specialist medical field that is still evolving but already demonstrating significant im‑ pact.

The BMSSN, recognised as the facilitator of the oldest and most advanced bariatric surgery industry in West Africa, attracted representatives from Benin Re‑ public, Burkina Faso, Togo, Côte d’Ivoire, Senegal and Ghana. The event underscored Nigeria’s pivotal role in forging regional col‑ laboration and highlighted the urgent need for shared learning and capacity building across the sub‑region.

Nigeria’s Leadership Role

Dr Abuchi Okaro, Founder and President of BMSSN and Bariatric Surgeon at Eurocare Hospital, Victoria Island, Lagos, explained that the session was designed to showcase developments in West Africa using data, insights and published material, while establishing a network of practitioners for closer collaboration.

“There is a clear need for this,” Dr Okaro stated. Bariatric sur‑ gery, he explained, is a procedure that enables obese individuals to lose weight by altering their digestive system to reduce calo‑ rie intake and absorption, or by modifying gut hormones that in‑ fluence appetite.

Conditions associated with obesity include hypertension, high blood pressure, type 2 diabetes, sleep apnoea, and high cholesterol. “The purpose of the event was to discuss how advancements in modern surgical operations have been shown to help patients control their conditions, and in some cases, eliminate or reverse them,” Dr Okaro said. He warned that untreated obesity can lead to kidney dis‑ ease, stroke, brain haemorrhage, heart attack and arthritis.

Rising Obesity In West Africa

The World Health Organization estimates global obesity prevalence at between 13 and 16 per cent of the adult population. Dr Timi Adenuga, BMSSN Sec‑ retary and Consultant General and Laparoscopic Surgeon at Getslim Bariatric Centre, Abu‑ ja, cautioned that West Africa is experiencing a rapid rise in obesity and metabolic disease. He noted that awareness of bar‑ iatric surgery remains limited, regional collaboration minimal, and Africa‑specific data on out‑ comes scarce.

Nigeria is best positioned to lead capacity enhancement in the sub‑region, having the oldest and most developed bariatric surgery industry. Bariatric surgery has been performed in Nigeria since 2012, mainly in Lagos, Abuja and Kano. Yet penetration remains low, at 0.04 per 100,000 people as of 2023, compared with 24 per 100,000 in Egypt and 0.9 per 100,000 in South Africa.

Despite this, Nigeria handles over 100 bariatric surgeries annually, far ahead of neighbouring countries. Burkina Faso, for instance, only began procedures in 2016 and has recorded 108 cases to date.

Challenges Facing Bariatric Surgery

Dr Okaro acknowledged that West Africa has not received sufficient support internally or externally to build a standard base for its 470 million population. Bariatric surgery requires highly skilled sub‑specialist sur‑ geons, significant training and financial investment. “Yet bar‑ iatric and metabolic surgery is not well appreciated in terms of the techniques applied,” he said.

The challenges are extensive. One major issue is the lack of awareness among the public, including potential patients, about the very existence of bariatric surgery. “The biggest reason for the lack of growth of our industry so far is that among the potential patients only a few know that the procedure exists,” Dr Okaro explained. “Indeed, it is a field that not that many doctors are adequately aware of.”

Another constraint is the lack of acknowledgement by potential patients that bariatric surgery is the most effective way to treat obesity. Many obese individuals remain in denial, believing their condition is temporary and can be corrected without specialist intervention. This perception is often reinforced by general practitioners who advise dietary adjustments alone.

Cost is another critical barrier. Bariatric surgery can cost up‑ wards of US$5,000 in many parts of West Africa and is rarely covered by health insurance. It is widely, but mistakenly, assumed to be cosmetic surgery rather than a medically necessary intervention for potentially life‑threatening conditions. While Chinese products are helping to reduce the cost of equipment and consumables, the procedure remains too expensive for most government health institutions to offer routinely.

Fear of surgery also deters patients, many of whom worry about dying on the operating table.

“Key challenges include, Public Awareness: Few potential patients know the procedure exists. Even many doctors remain inadequately informed.

“Patient Denial: Many obese individuals believe their condition is temporary and can be corrected without intervention, often encouraged by general practitioners who recommend dietary adjustments alone.

 “Cost: Procedures cost up‑ wards of US$5,000 in many parts of West Africa and are rarely covered by health insurance, due to the mistaken belief that bariatric surgery is cosmetic rather than medically necessary.

“Fear of Surgery: Patients of‑ ten fear death during operations, despite evidence to the contrary.”

Outcomes And Data Dr Adenuga presented data that directly counters these fears. The mortality rate within 30 days of bariatric surgery in Nigeria is just 0.2 per cent. Outcomes are strong: 85 per cent resolution of hypertension and 97 per cent complete resolution of diabetes. Only 5.3 per cent of patients re‑ quire re‑admission.

However, success depends on patient discipline, particularly regarding diet. Nutrition plays a critical role before and after surgery.

 Nutrition And Lifestyle

Sherese Ijewere, a leading nutritionist in bariatric and metabolic surgery, emphasised that nutrition is vital even before surgery. “It needs to be clear how the patient became overweight in the first place,” she explained. Patients undergo a two‑week pre‑operation diet to shrink the liver, making surgery safer.

Post‑surgery, patients consume only liquids for three to four weeks, gradually increasing density. For up to a year, they must work closely with nutritionists. Ijewere reported that 80 per cent of patients adhering to the process reversed their ailments and achieved healthier lives.

She stressed the need for a multi‑disciplinary team including cardiologists, psychologists, nutritionists, endocrinologists and personal trainers to support patients alongside surgeons.

Regional Collaboration

Dr Okaro concluded that the purpose of the session was to form collaborations. “If we can learn from each other we can make better decisions, we can do surgery, we can select our patients better and we can offer them better outcomes. We hope that in the years to come we will be hearing positive results from this first of its kind sub‑regional interaction on metabolic and bar‑ iatric surgery.”

 Broader Implications

The session highlighted Nige‑ ria’s leadership in bariatric surgery within West Africa, under‑ scoring both achievements and challenges. With obesity rising rapidly, the need for awareness, affordability, and regional cooperation is urgent. The BMSSN’s initiative at the WACS conference represents a significant step to‑ wards building capacity, sharing knowledge, and improving outcomes for patients across the sub‑region.

Nigeria’s experience demonstrates that bariatric surgery can deliver measurable health benefits, including resolution of hypertension and diabetes, when combined with disciplined life‑ style changes and nutritional support. The collaboration initiated in Accra provides a plat‑ form for West African countries to share expertise, address barriers, and expand access to this life‑saving intervention.

As the obesity epidemic continues to grow, the importance of regional cooperation cannot be overstated. The BMSSN’s leader‑ ship offers a model for how specialist medical societies can drive progress in emerging fields, ensuring that patients across West Africa benefit from advances in surgical science and preventive healthcare.