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February 18, 2019

Take a Weight Off: Bariatric Surgery

Take a Weight Off: Bariatric Surgery

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As obesity rates in the UK continue to climb at an alarming rate, bariatric surgery offers patients a lifeline while providing cost-effective relief to the NHS

Recent figures published in the March 2018 House of Commons Obesity Statistics report show that obesity levels in the UK have increased from 16 percent to 26 percent since 1993—meaning that we now have the second highest rates of obesity in Europe. Today, 61 percent of the nation is classified as overweight or obese, a condition that contributes great risk to various types of cancer, Type 2 diabetes, cardiovascular diseases, high blood pressure and respiratory problems. While doctors will advise that lifestyle changes—including a diet overhaul and exercise—are pertinent to successful weight loss, for some, additional procedures like bariatric surgery pose a radical but necessary option to kickstart a healthy life. Between 2015 and 2017, some 18,528 weight loss surgeries took place in the UK. Yet some medical experts have warned that thousands more operations should be made available to those who require it, as the cost of surgery offsets other obesity-related medical care costs. It seems that the climbing rates of obesity and the high medical costs that come with them may actually be threatening the sustainability of the NHS. 

As with most surgical procedures, bariatric surgery does carry risks, and potential patients should consider them carefully before opting for the drastic procedure. Patients may be at risk of wound infections, a blocked gut or a leak that can cause infections inside the stomach, the gastric band falling out of place and developing gallstones. Weight loss surgery can also increase the likelihood of malnutrition, as it may become more difficult for the gut to absorb vital nutrients from food. For this reason, surgeons may recommend patients take extra daily nutritional supplements for life after the operation. 

With this in mind, however, experts surmise that the health benefits do outweigh the risks. Not only does bariatric surgery provide a cost-effective resolution for the obesity epidemic, it can lead to significant weight loss in a short period of time and has been shown to improve—and in some cases eradicate or reverse—conditions like high blood pressure and Type 2 diabetes. 

Do I qualify? 

To receive bariatric surgery on the NHS, patients must meet certain criteria. Patients will only be offered this procedure if they have a body mass index (BMI) of 40 or more. This may be reduced to a BMI of between 35-40 if the patient has an obesity-related condition (like diabetes) that could be improved should surgery take place. In most incidences, patients who have committed to trying other mainstream weight loss methods such as regular exercise and healthy diets with no luck will be recommended the procedure. Weight loss surgery is also available privately, although qualifying criteria may differ from provider to provider and costs can be high. 

Types of surgery 

The type of weight loss surgery offered will depend on a patient’s specific needs. There are various types of bariatric surgeries available. These procedures are typically carried out under anaesthetic via laparoscopic (keyhole) surgery to minimise invasiveness.

Gastric band. In this procedure, an adjustable silicone band is placed around the top of the stomach; this band is tightened around six weeks following surgery. The narrow passage between the top and bottom halves of the stomach works to limit food intake, so that patients feel fuller, quicker. 

Gastric bypass. Surgical staples are used to create a pouch at the top of the stomach which is then connected to the small intestine. Food then effectively bypasses the rest of the stomach. 

Sleeve gastrectomy. A restrictive procedure, surgeons remove around 75 percent of the stomach, so that what remains is much smaller and less calories can be consumed.

Gastric balloon. A soft balloon is placed into the stomach using a thin tube passed down the patient’s throat. Once in place, the balloon is filled with air or saltwater, making it difficult for individuals to eat as much before   feeling full.

Biliopancreatic diversion. A biliopancreatic diversion is very similar to a gastric bypass, but it carries more risks. This operation involves creating a small stomach pouch and connecting it further up the small intestine than with a gastric bypass.

Which Procedure is best?

Each type of weight loss surgery results in significant weight loss, but there are differences. According to the NHS, you are more likely to lose weight following a gastric bypass or sleeve gastrectomy than following a gastric band procedure. It is also crucial to consider the risks associated with each. Surgical complications are more likely after a gastric bypass or sleeve gastrectomy. For further advice, speak with your surgeon.

Life after surgery

Patients are typically able to leave the hospital a few days following bariatric surgery and can resume normal activity around six weeks post-op. Doctors require that patients commit to regular follow-up appointments for the rest of their lives to keep an eye on their general health and wellbeing. To help keep the weight off, patients should eat a healthy, balanced diet and commit to the government-recommended 150 minutes of exercise each week.

Did you know?

Men are more likely to be obese than women

Source: healthierweight.co.uk

617,000

The number of admissions in NHS hospitals where obesity was a factor 

Source: Statistics on Obesity, Physical Activity and Diet—England 2018

6%

of all cancers are caused by obesity, which is the second-biggest cause of cancer after smoking

Source: Cancer Research UK

This article was originally published in Live to 100 with Dr Hilary Jones. Read the digitial edition, here.