The Association of Bariatric and Metabolic Surgeons of Uzbekistan (UzAMBS) and Dendrite Clinical Systems will establish a National Registry of Bariatric and Metabolic Surgery of Uzbekistan. The purpose of the Registry is to collect information on patients and bariatric procedures in the country so researchers can use the data to improve outcomes in patients. Bariatric News spoke to the President of UzAMBS, Professor Oktyabr Teshaev (Head of the Department of Surgery of the Tashkent Medical Academy, Tashkent, Uzbekistan) about the rise of obesity rates, the evolution of bariatric surgery and the importance of creating a National Registry of Bariatric and Metabolic Surgery in the country.
According to the results of a study conducted jointly with the World Health Organization (WHO) among the population of the Republic of Uzbekistan aged 18-64, half of the population is overweight. According to the results of this study:
20 percent of the adult population of the country are living with obesity
The average body mass index (BMI) in Uzbekistan is 26.5 kg/m2, which is the highest in Central Asia. It is expected that by 2060 the damage to the economy from obesity will increase to $21.6 billion, which is equivalent to 4.7% of GDP.
The average BMI in Uzbekistan has increased by 0.12 points annually since 1991 and reached 25 kg per square meter in 2006.
An elevated BMI is one of the main risk factors for non-communicable diseases such as cardiovascular diseases, diabetes, musculoskeletal disorders and cancer.
According to WHO forecasts, by 2030 and 2060, the proportion of adults who are overweight or obese will increase to 59% and 80%, respectively. The proportion of adults with obesity will increase from 18.9% in 2020 to 25% by 2030 and to 50% by 2060.
In 2023, the National Strategy "Population Health-2030" was developed in Uzbekistan, in which The Institute of Health and Strategic Development was created. By the decree of President Shavkat Mirziyoyev in September 2023, a ‘Program for the Formation of a Healthy Lifestyle and the Popularization of Proper Nutrition for 2024-2026’ was developed to improve the activities of the Ministry of Health. The agency was instructed to prepare a document “with the involvement of international organizations and foreign consulting companies based on advanced foreign experience” (the same decree mandates the completion of the implementation of health insurance by the end of 2026). Professor Teshaev added that like many countries, the main reasons for rising obesity rates are excessive calorie consumption and a lifestyle with a lack of physical activity.
“In my opinion, the driving forces in the increase in the number of people with excess body weight and obesity are physical inactivity and improper, irrational nutrition. Perhaps the most significant and impressive component of Uzbek culture is, without a doubt, the modern cuisine of Uzbekistan. Traditional dishes are extremely diverse, rich and fatty composition. The traditional range of food products is determined, firstly, by the way of life and various religious and cultural components of the peoples of Uzbekistan and, secondly, by economic and natural conditions,” explained Professor Teshaev. “Therefore, regional cuisines and the process of preparing dishes differ significantly from each other. Uzbek cuisine was formed under the influence of the Great Silk Road, the food traditions of the Near and Middle East, as well as Uyghur, Indian cuisine. Most dishes are prepared from grains, flour, milk and meat. Vegetables, fruits, greens and legumes are always on the table, and flour dishes are the main part of the local cuisine. This is the main driving force behind excess weight and obesity in Uzbekistan. To prevent obesity, it is necessary to promote a healthy lifestyle, balanced nutrition and physical activity. These activities should be started from early childhood, at school, at universities and implemented in the daily life of every citizen of the republic.”
UzAMBS
In Uzbekistan, bariatric surgery began to develop in 2015, previously only a few surgeons were engaged in obesity surgery in the 1980-90s. In 2015, two surgical centers (the Republican Specialized Scientific and Practical Center of Surgery named after V Vakhidov and the Department of Surgical Diseases of the Tashkent Medical Academy) began performing bariatric surgeries. In March 2020, UzAMBS was created after the approval by the Ministry of Justice of the Republic of Uzbekistan. The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) accepted UzAMBS into its structure in September 2020.
The objectives of the Association are: developing recommendations for the treatment of patients suffering from obesity, defining uniform indications and requirements for the surgical treatment of obesity and associated metabolic disorders, organising seminars and creating centers for training specialists, providing reliable information to patients in need of treatment, exchanging information in the field of bariatric and metabolic surgery, maintaining statistics on operations performed in the country.
Today, bariatric surgeries are performed in more than 30 medical centers in the Republic and more than 50 specialists have been trained in training centres for bariatric surgeons. There are about 100 bariatric surgeons in the country who perform bariatric surgery who perform approximately 3,000 bariatric procedures annually, of which approximately 60% are sleeve gastrectomy, 30% OAGB\MGB, 5% RYGB with the remaining 5% are other types of surgeries.
He said that in Uzbekistan, specialised medical care is available to everyone on a paid basis, insurance medicine has just begun to develop. The state provides free treatment to all citizens for urgent emergency pathology, free treatment is provided to children under 18, all patients with oncological, infectious and obstetric pathology.
“However, the need for bariatric surgeries in the country is very high. The number of surgical centers engaged in bariatric surgery is growing rapidly, the number of bariatric surgeons is increasing, complications are observed revision bariatrics are increasing,” Professor Teshaev commented. “Therefore, the creation of a national bariatric registry will allow us to evaluate the technical characteristics of bariatric interventions performed in different centers, the geographical characteristics of the distribution of bariatric patients, track strategies for choosing types of surgical treatment, systematize data on the characteristics of management and clinical tactics, and evaluate long-term results. Systematisation and unification of the results of bariatric interventions will allow us to audit and certify clinics, which will obviously improve the quality of bariatric care in the country. We analysed the activities of several companies in the field of programming and creating registers, but having studied the activities of Dendrite Clinical Systems and learned the structure of the IFSO Registry, we came to the conclusion that it would be right to entrust the creation of the National Register of Bariatric Surgeons of Uzbekistan to Dendrite.”
The National Register of Bariatric Surgery of Uzbekistan will be financed by the members of UzAMBS and mainly collect the following data:
data on all types of bariatric surgeries
patient data before and after surgery
general clinical and biochemical blood tests
data from instrumental studies of ultrasound, X-Ray, MSCT, EGDFS, ECG, etc.
selection of bariatric surgery method
postoperative management
postoperative observation with repeat examinations one, three, six, 12 and 24 months
analysis of remote results of surgeries performed
complications and quality of life after bariatrics
data on bariatric surgeons
performance indicators of surgical centres, as well as statistical processing of the obtained data and creation of reports
“In 2022, we held the first congress of the Association of Bariatric and Metabolic Surgeons of Uzbekistan. Leading bariatric surgeons and scientists from 18 countries participated in the congress with reports. The total number of offline participants was 367 and online more than 3 thousand,” he added. “This year, on October 11-12, we plan to hold the 2nd congress of our association and I would like to invite colleagues from around the world to participate in our 2024 Congress.”
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