Information on Weight Loss Surgery

Thinking about weight loss surgery?

According to a BBC report the number of people who are obese has tripled over the last 20 years, and is continuing to rise. It states that most adults in the UK are overweight and 1 in 5 is obese. A government report showed that obesity caused 30,000 premature deaths in 1998 alone and that figure is increasing every year.

For people who are over weight or obese, the first option is usually to try a diet of their own. If this fails then they may seek the support of an established weight management group, such as weight watchers or slimming world. They may look for support from their doctor who may, in turn check for bodily dysfunction, such as under an under active thyroid gland or diabetes.

But if all that has failed then what are the options?

In the last 10 years, a more radical but effective solution of weight loss surgery has been available to people who are class 2 obese or above, meaning that they have a body mass index of 35 or more. A person's body mass index is calculated using their weight and height. As an example, a male who is 5' 9" (1.75 metres) and weighs 16 stone 12 pounds (107 Kgs) or a woman who is 5' 4" (1.62 metres) and weighs 14 stone 8 pounds (93Kgs) both have a body mass index of 35.

The two most popular and most proven methods of weight loss surgery are the lap band and the gastric bypass.

The Lap Band

The lap band is the simpler of the two procedures and involves the surgical introduction of a physical band, a little bit like a tiny rubber ring that would be used around a childs waist for swimming. Under general anaesthetic, the band is placed at the bottom of the pipe that enters the stomach (the oesophagus). Once in place, the band can be inflated with saline solution which causes it to tighten and, therefore restrict the flow of food that is allowed into the stomach.

Post operative recovery time is 7-10 days. The patient must still follow a diet but the band enforces a restricted flow of food for the body to absorb. If the patient over eats then they may be sick or experience feelings of indigestion. The hope is that they will quickly fall in line with the limiting factors of the band in order to avoid these undesirable feelings. The fact that they have also spent about £7000 having the band fitted and spent 2-3 nights in hospital may add to the patient's determination and have some placebo effect. The band is fitted laprascopically which means via keyhole surgery, hence the name 'lap' band. This means that the patient has very little scarring after the operation. The band will need inflating from time to time, which involves further trips to see the surgeon.

The lap band is considered an efficient method of surgical weight loss for people with a body mass index up to about 45. For patients above this weight, the general feeling is that the lap band is not robust enough for the task in hand and patients are advised to consider the gastric bypass.

Gastric Bypass

The Roux-en-y gastric bypass is more involved as an operation but generally considered to be easier to live with and more effective, particularly for people with a very high body mass index. The bypass involves reducing the size of the internal stomach, under general anaesthetic and shortening the length of the large intestine.

As anyone who has tried to diet will undoubtedly agree, the biggest problem with sticking to any diet is simply that when the permitted food rations have been consumed, you don't feel full. Hence you are likely to continue wanting to eat. The beauty of the bypass operation is that, by reducing the size of the internal stomach the patient only needs to consume a very small amount of food to get the feeling of being full. The shortened intestine results in less calorie absorption and consequently the patient loses weight but doesn't feel like they suffering the hardships of an enforced diet.

A typical cost for the gastric bypass is between £10,400 and £12,900, depending on the starting body mass index of the patient and whether the surgeon's choice of technique involves keyhole surgery or open surgery. The keyhole surgery obviously leaves less scarring, though another school of thought is, by performing the procedure through open surgery, that the operation is intrinsically quicker and therefore less risky with regards to the anaesthetic. Some surgeons also take the view that any potential leakages are more likely to occur if the operation is being carried out with extending tools, cameras and television monitors rather than open, face to face surgery where the surgeon can properly see what they are doing. If an internal leak does occur post operatively following the keyhole method, it can be occasionally necessary to revert to open surgery in order to locate and mend the problem. If open surgery takes place then the patient can expect a scar running from the bottom of the breast bone down vertically towards the belly button of approximately 7-9 inches, though this does fade in time. The stay in hospital is usually 5 days with most patients returning to work 2 weeks after the operation.

The most important decision with any surgical procedure should be the choice of surgeon and the facilities of the hospital in which it will be carried out. Remember that a weight loss operation is not going to a cosmetic surgeon to have your button nose made a little cuter! These are major operations and, let's face it if something goes wrong with your internal gastric plumbing system then you can die! That is why it is vital to pick a highly experienced and reputable consultant surgeon. Make sure that the procedure will take place in a hospital with a high dependency unit and not just a clinic, like many of the high street companies work from. Make sure that you get the initial consultation with the surgeon themselves and not a salesperson or patient advisor who is working on commission.

For details of your nearest experienced surgeon for either lap band or gastric bypass surgery and for a fixed price for each operation, contact us on 01254 832148.

Written by Marcus Landauer.