Obesity Surgery

What exactly does it entail, and when should you have it?

Obesity is now a worrying epidemic in the UK with the latest figures from the Health Survey for England showing nearly 62% of adults and 28% of children under 16 as overweight or obese.

The Body Mass Index is a measurement of body fat based on height and weight with a healthy BMI considered as between 18.5 - 24.9. A significant proportion of overweight adults have a BMI higher than 30 which is considered obese.

As well as the physical and psychological impact of being obese, such as decreased mobility, low self-esteem and mental health issues, there are many serious health risks including a higher likelihood of developing heart disease, certain cancers and type 2 diabetes.

With the NHS currently unable to meet demand for weight loss surgery, increasing numbers are choosing to pay for the treatment themselves, and have it carried out privately. However, it must be remembered that there are a number of alternative routes that are recommended by healthcare professionals as first port of call. These include significant changes to diet and exercise routines that should be instructed and monitored by you GP to ensure they are carried out safely.

In all cases, weight loss surgery is only recommended for those whose obesity poses a significant risk to their health, and never for purely cosmetic reasons. The type of surgery you have will depend on your individual circumstances. Some of the most common are listed below:

Gastric Balloon (endoscopic intragastric balloon)

For this procedure an inflated silicone balloon, filled with a saline solution,  is placed inside the stomach for six months. This leaves less room for food and patients therefore feel full more quickly and eat less as a result. It is most suitable for those who have a BMI of 30 to 40 and is helpful to kick start weight loss. It is a non-invasive, same day, outpatient procedure and typically only takes 2-3 days to fully recover. Patients should expect to lose up to 30% of their excess weight.

Gastric Bypass (“Roux-en-Y gastric bypass”)

During this procedure, the intenstines are re-routed so most of the stomach is by-passed. This makes the patient absorb less food and therefore feel full sooner. Weight loss is probably the most dramatic out of all the procedures with significant improvements in obesity related health conditions and generally very good long term results. However, there’s a small risk of nutritional deficiencies and the procedure is irreversible. Typically patients will lose up to 75% of their excess weight within 2 years.

Gastric Sleeve (vertical sleeve gastrectomy)

This surgery removes 75 - 80% of the stomach thus limiting the amount you can eat. The patient will feel full after eating much smaller portions of food. Sleeves have recently surpassed the gastric bypass in popularity as weight loss is rapid and the procedure can dramatically improve or even cure obesity-related health problems. Although it is similar to a bypass, it is a less complicated procedure and digestion is unaffected so the patient doesn’t suffer from nutritional deficiencies. Typically patients will lose up to 75% of their excess weight.

Gastric Band (adjustable gastric band)

Gastric or Lap-Band surgery is where an adjustable band is wrapped around the upper part of the stomach, reducing its size so the patient feels fuller more quickly after eating. Again it can improve or cure obesity-related health problems and is simpler than a bypass or sleeve with a faster recovery time. However, aftercare is necessary as the band has to be adjusted according to how full patients feel after eating. Typically patients will lose between 25- 75% of their excess weight.

Surgery for obesity (otherwise referred to medically as ‘Bariatric Surgery’) has become increasingly popular with the rise of the ‘self-pay’ procedures that patients choose to instruct and fund themselves.

If you have been advised to proceed down the surgical route, and wish to speed up the process by having the procedure done privately, your Bariatric Surgeon will discuss each option in more detail and will provide further information, aftercare and support. It is also vital that following the procedure  you introduce changes to your lifestyle and eating habits in order to optimise the results of your surgery.

As with all private medical treatment, you should ensure your surgeon is reputable, qualified and registered and look for previous patient testimonials to help make your choice.

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