The National Obesity Surgery Centre

US singer Carnie Wilson had gastric bypass surgery in 1999 and lost half her body weight. She weighed 300 pounds before the surgery and she lost 150 pounds. Ten years later she is back up to 212 pounds.

Losing weight with a bypass is no guarantee that it will stay off as the stomach typically stretches again over time. Gastric bypass is an extreme and controversial treatment for obesity.

One study showed that one in five patients had complications after surgery including heart attacks and strokes. Another study showed that the mortality rate for gastric bypass patients is one in two hundred.

Regaining weight after gastric bypass creates physical and emotional problems. Carnie Wilson says she is determined to lose her weight again.

Celebrity Health & Fitness

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Our view on gastric bypass remains the same. This is radical surgery that changes the anatomy of the stomach. The evidence is that a high percentage of people who have lost weight after gastric bypass will eventually regain some, or all of it, after a time lapse of 5 years. Why would anyone choose this option when there is a far easier solution that doesn’t change the anatomy of the body in any way, lasts for a lifetime and is fully adjustable? Yes, we are talking about the gastric band!

1300 people completed a survey asking how they would like to lose their excess weight. Liposuction was the most popular choice with women (34%) followed by gastric banding (26%) and cutting calories (14%).

8% would consider a tummy tuck, 6% would use a combined approach of diet and exercise and 2% said they would exercise more. The survey concluded that 56% of people in the UK would rather lose weight through surgery than the conventional way of eating less and exercising more. 

Telegraph

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It was interesting to hear that 26% of those surveyed would opt for a gastric band and 14% would cut calories. However, it is misleading to class tummy tuck and liposuction as weight loss procedures. Tummy tuck (abdominoplasty) removes loose skin from the abdomen and the layer of fat underneath. This is not an operation for someone who is generally overweight and the usual requirement is that patients are as close to their normal weight as possible prior to surgery. Liposuction is  a procedure for removing areas of spot fat that won’t respond to diet or exercise. Both surgeries will probably offer an actual weight loss of between 2lb and 3lb.

If you are serious about losing weight then try cutting your calories. If that doesn’t work for you, think seriously about a gastric band or a gastric balloon. We know that they work!

Gastric bands are rarely removed but should it become necessary it is a straightforward procedure. As gastric banding does not alter the anatomy of the stomach, taking out the band does not involve the reconnection of any detached organs.

Gastric bypass reversal should be avoided. If we consider the original operation, the stomach is divided and most of it’s volume is cordoned off with staples. The stomach is rerouted to connect it to the middle of the small intestine. To reverse this at a later date the surgeon must divide the stomach and the intestine where they had been sewn together and use a stapling device to rejoin them in the original spot. However, the stomach will not be the same as it was before the gastric bypass as it is impossible to mend several nerves that help with normal gastric function.

When would surgeons reverse gastric bypass surgery?

Only when the patient experiences significant complications such as infection, a hernia (along the original incision), a leaking stomach (that has been punctured during surgery), malnutrition (because a portion of the small intestine is no longer in use).

Gastric bands carry fewer risks because they are less invasive.

Slate Magazine – USA

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This is a subject constantly debated between medics at NOSC. The conclusion to any discussion regarding gastric band versus gastric bypass is always the same. We fail to see the justification in offering anyone a gastric bypass when there is a safer, less invasive surgery available. Adding weight to our argument is the data that shows the percentage of gastric bypass patients who have regained their weight after a period of 5 years. As a gastric band is adjustable, the patient has a lifetime of control.

And for those patients who want the quickest and easiest procedure, we suggest they choose the gastric balloon!

More than 30,000 people in Britain will die this year because they are obese. In 2007 the NHS spent £4.2 billion on treating obesity. It is estimated that by 2050 this will rise to £10 billion.

Hospitals and GP surgeries are equipping themselves with extra wide wheelchairs, stronger hoists and reinforced operating tables. A wider wheelchair can cost £1200 more than the standard version. CT and MRI scanners with three times the usual space each cost £1 million. Drugs to treat the conditions caused by obesity, such as heart disease, diabetes, high blood pressure and some forms of cancer cost twice as much as the money spent on people with a healthy BMI. Treating obesity takes a heavy toll on the work of GP surgeries because of additional screening.

Daily Mail

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This is a situation that cannot continue. Perhaps there should be a move to partial funding of gastric balloon and gastric band procedures. It is obvious that the NHS are not financially in a position to provide bariatric surgery for everyone who would benefit. Likewise, many people who would like to have a gastric band or gastric balloon fitted privately, cannot afford to pay the full amount. Wouldn’t it make sense for the NHS and the private sector to work together so that more people can be treated?

85% of people in Wales will be obese by the year 2019. That is the dire prediction, unless we take drastic action now.

Wales has some of the highest rates of childhood obesity in the world and is the fattest nation in the UK, with 57% of adults classed as overweight or obese.  Research by Swansea University in 2005 found 8% of girls and 5% of boys are obese by the age of five. 22% of 13 year old boys and 16% of girls are classed as overweight or obese.

Medics warn that Wales is in the grip of a complex eating disorder that is shortening lives. Professor John Baxter is president of the Obesity Society and he says “It is hard for health commissioners to extend obesity surgery services because it is unpopular with the public. There is prejudice against obesity. The lay population’s view is ‘it’s their own fault. Why should we spend money on fat people?’ Until you get a better understanding of obesity it’s going to be difficult.” To those who say people must eat less, Professor Baxter says diets only work in the short term. “People need long term help and sometimes medical intervention. Obesity is a problem we don’t fully understand.”

Wales Online

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This is an interesting report that clearly shows the extent of the obesity problem in Wales. Yet again it would seem that gastric balloon and gastric band procedures are low on the list of healthcare priorities. People of normal size cannot understand the complexities of weight loss and there is often an opinion that ‘fat people are lazy and have no self -discipline.’ In our experience this is usually far from the truth. Obesity is a chronic disease of which we have a limited understanding. The more that people try to lose weight, the worse the problem becomes. This is the reason that people opt for bariatric surgery as a means to gaining life long control.

61 year old Juliana Heron from Sunderland is half the woman she was. After struggling with her weight for most of her life she decided it was time to take action when she topped the scales at 23 stones.

A typical yo-yo dieter, she ate big meals and had a passion for chocolate. She would diet, lose weight and then put it back on. She has arthritis and her extra weight was just too much for her knees.

Making the decision to go ahead with a gastric band was one of the best choices of Juliana’s life. She now weighs 10 stones, after a massive weight loss of 13 stones. She said “The gastric band surgery has changed my life. The obvious effects are the weight loss but what people don’t see are the changes I have made. I only eat small meals now and the thought of chocolate makes me feel sick. I would recommend a gastric band to anyone in my position.”

Journal Live

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Well done Juliana. Yet another fantastic gastric band success story. Bet your knees aren’t giving you too much trouble now!

Obese patients in Manchester have been told that they do not qualify for weight loss surgery because they are not fat enough.

Patients used to be eligible if their BMI was over 40 but the limit has now been raised to a BMI of 50. This decision has upset patients who thought they were eligible but have now been told they cannot have surgery.

Jacquie Coleman, 53, from Manchester, was recommended for surgery after she she hit 16 stone. She has shown her commitment to a change in lifestyle by working with a dietician to lose a stone in weight. Now she has been told she cannot have surgery, even though she can’t exercise because of arthritis in her knees. She has diabetes and is currently waiting for a second knee replacement.

A spokesman from the Greater Manchester Public Health Network said “Surgery should be rationed. We have a limited amount of resources and we have to prioritise services.” 

Manchester Evening News

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As the obesity epidemic escalates, more and more people will attempt to access treatment via the NHS. Providing surgery to people with a BMI over 40 is a costly business. However, if the NHS don’t pay up now, they will have to pay up in the future, when the inevitable effects of obesity become apparent. We will see a rise in diabetes, joint replacement surgery, cardiac and many other debilitating conditions.

Like any other business the NHS has to budget for its provision of services. How it chooses to proportionally fund these services will remain a very difficult choice.

Up to 25,000 Scots who could be eligible for gastric band surgery are being denied the opportunity to transform their lives. The number of bariatric procedures carried out in Scotland on the NHS each year is between 150 and 180.

Type 2 diabetes, which can lead to serious health complications, is one of the country’s fastest growing conditions. But people are being denied gastric band and gastric balloon procedures because health boards are unwilling to finance them.

Although research has shown that obesity surgery can have a major effect on improving the health of obese people, Scotland has one of the lowest rates of bariatric surgery in the world. In Scotland only 0.8% of those eligible and willing to have a weight loss procedure receive treatment. This compares with 1.2% in England, 5.5% in Sweden and 9% in the United States.  

If more patients were offered treatment, their health could be improved and the NHS would save money over the long term.

Scotland on Sunday 10/1/2010

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Each year we see an increasing number of people embark on the life changing journey that results from gastric band surgery and the non-surgical gastric balloon procedure. Patients experience incredible health benefits and generally feel fitter and enjoy improved mobility. Although people talk about the physical benefits, we also see a marked improvement in patients who have suffered with depression. If the NHS in Scotland could fund twice the number of patients each year, it would bring them in line with the NHS in England. And they would still both be lagging behind the rest of the world!

Research data has been gathered from more than 120,000 female nurses over a period of 34 years. The study showed that the maintenance of a healthy weight throughout adulthood may be vital to good health as we get older. In fact, women who put on weight as they approach middle-age stand an 80% less chance of enjoying a healthy old age. The researchers found that for every 1kg of weight gain from the age of 18, the odds of a healthy old age decreased by 5%.  Obese women with a BMI over 30 were 79% more likely to develop a chronic disease as they aged, compared to women with a BMI of 25 or less.

British Medical Journal

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This study confirms what we have known all along. Control your weight and the chances are that you will live a fuller, healthier life. We all know how the excess pounds affect your quality of life and as we approach middle-age we start to develop aches and pains, joint problems and our general mobility starts to suffer. Life just isn’t as much fun as it used to be! We have found that many women use the gastric balloon at this point in their lives, to improve their lifestyle.

When they realised her job was on the line, Elaine McLoughlin’s family clubbed together to pay for her gastric band surgery. At 25 stone and a size 38 she couldn’t even walk 100 yards. She was desperate to lose weight and had tried diets and slimming clubs, but as a comfort eater, she always regained the weight she had lost. She was so obese she was terrified she would die. Following her gastric band surgery Elaine lost over 12 stone and is now a size 14. She said “the love of my family has saved my life” 

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Thankfully, Elaine’s mother and sisters were able to give assistance with paying for her gastric band. This has turned Elaine’s life around. Scotland is one of NOSC’s busiest areas for the placement of gastric bands and gastric balloons and many of our patients have similar results to Elaine.