Eman, whose weight was 500kg until March 7, underwent bariatric surgery earlier in March at Saifee Hospital in Mumbai now weighs 238 kg. Dr Muffazal Lakdawala who has performed the surgery siad Eman has lost 262kgs . She had been flown down from her home in Alexandria in Egypt to Mumbai by a cargo plane and was then transported from the airport till the hospital in a mini-truck.
Eman who is currently undergoing treatment at Saifee Hospital needs physio-therapy as she was bed ridden for 25 years said Dr Lakdawala
In a genetic test done on Egypt’s Eman Ahmed (36), who is known as the world’s heaviest woman, it has been found that she has a rare gene defect that causes obesity and she is the only person in the world to be detected with this defect.
Explaining the technical aspects of the report, Dr Muffazal Lakdawala, the bariatric surgeon who operated on Eman, said the gene identified as the cause of obesity in Eman is a “homozygous missense variant c.1055G>A, p.(Cys352Tyr) in the LEPR gene”.
Dr Lakdawala said this variant has been previously detected in one individual during a research carried out by Personalized Diabetes Medicine Program, University of Maryland School of Medicine, and has been classified as a “variant of uncertain significance”.
However, in Eman’s case it has assumed pathological consequences, leading to her obesity.
“Eman happens to be the only one in the world with this gene defect which causes obesity,” added Dr Lakdawala
Doctors said Eman also has another gene defect, SDCCAG8 associated with Phenotype Bardet‐Biedl syndrome, Senior‐Loken syndrome, but doctors say they believe it may not be a significant cause of obesity in her case as the leptin receptor (LEPR) Gene.
LEPR is involved in regulation of body weight. The protein is found on the surface of cells in many organs and tissues of the body, including a part of the brain called hypothalamus. “The hypothalamus controls hunger and thirst as well as other functions like sleep, mood, and body temperature. It also regulates the release of many hormones that have functions throughout the body,” said Dr Lakdawala.
After reaching Mumbai, Eman was put on a special high-protein, liquid diet which made her lose 100 kilos before she was taken in for surgery.
The Core Diagnostics Pvt Ltd had carried out the special gene study on Eman where 91 different types of genes isolated with obesity related syndrome were checked.
“There is a hormone called leptin which comes from fat tissue and tells the brain when fat stores are being depleted. In Eman, the docking station in the brain that leptin plugs into seems to be very defective so leptin doesn’t send its signal. Because of this, from early on in life, Eman’s brain perceives that she is constantly starving,” explained Dr Lakdawala.
He added that this has led her to constantly seek food and store it avidly in her body as fat and conserve energy. Unfortunately, doctors say there is no specific treatment for this condition currently. “The operation that she has had may have some benefits but does not deal with the underlying problem,” said Dr Lakdawala.
He further said that new drugs are being developed which may be able to, at least partially, “bypass” the signalling block in her brain. These new drugs may hold some promise but it is too early for these drugs. “If she has access to these drugs and they are effective, we have a solution for her obesity. If not, she may need a more radical surgery which causes malabsorption a little later in life,” said Lakdawala.
Talking about the next course of action for Eman, Lakdawala said she will continue to be on a strict diet along with physiotherapy. “She will undergo a brain CT scan in the next two weeks as she had a stroke earlier and never underwent a CT scan before because of her weight. We then plan to send her home,” said Lakdawala.