The National Obesity Surgery Centre

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.

Professor Chris Hawkey, president of The British Society of Gastroenterology  has warned that if we carry on as we are, nine out of ten adults will be obese by the year 2050.

Speaking at the Gastro 2009 conference, he suggested that  fad diets are making us fatter. He said “In the whole of human history there has never been anything quite like this. If current trends continue, obesity will be the main cause of death and the biggest cause of liver disease. Fad diets, such as high carbohydrate or high protein plans, can be extremely unhealthy and won’t work in the long term. Weight loss aids, such as appetite suppressants, may produce short term results but the weight soon creeps back on”.

Daily Express

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NOSC patients are, without exception, yo-yo dieters. The majority have tried many different ‘diets’ over the years and they have all ended up much heavier than they were in the first place. It could be said that they have dieted their way up in weight. At the point in their lives where they choose the intervention of a gastric balloon or a gastric band, they have come to realise that the only way forward is to get off the diet bandwagon once and for all.

The vast majority of people who have a gastric balloon inserted or a gastric band fitted, embark on a life changing mission. They find that they can control their portion sizes, they can change their behaviour around food, they don’t have to starve themselves and they can gain control. As they lose their weight, they will follow a healthy, nutritional diet but will also learn how to enjoy ‘forbidden’ foods in moderation.

At last – no more diets!

A study recently published in the Journal of Clinical Endocrinology & Metabolism showed that overweight women who had weight loss surgery before becoming pregnant might help break the cycle of obesity within their families.

It was found that children born to women who had weight loss surgery, such as gastric band, before pregnancy, have improved heart health and a lower risk of obesity compared to their siblings. In fact they are three times less likely to become obese compared with siblings born before weight loss surgery.

Previous research shows that weight and a tendency to develop diabetes and heart disease can affect the health of the unborn child, exposing the child to metabolic problems related to obesity.  

The Institute of Medicine of the National Academy of Sciences updated their guidelines on the correct weight for young women and the limits on pregnancy weight gain. Women with a BMI over 30 are advised to gain no more than 20lbs.

Tribune newspapers 14/9/09

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There is a great deal of discussion around the whole subject of pregnancy and pre and post pregnancy weights. Gaining significant amounts of weight during pregnancy will put the child at risk on several different levels.

Many women with a BMI over 30 find it extremely difficult to conceive and researchers in an Australian study showed that the gastric balloon procedure produced a higher rate of pregnancy than IVF treatment.

When Peter O’Keefe told his wife Paula that he’d had enough of being overweight, she thought he was about to embark on yet another diet. But when Peter told her of his decision to have a gastric band fitted she knew it was time to do something about her weight too.

The couple from Taunton had tried many diets and failed often. They might have spent their married life getting fat together, but they have spent the last 18 months getting slimmer and fitter together. Between them they have shed 11 stone – with Paula going from a size 24 to a size 12 and Peter going from a size 40 waist to a trim 34.

Baby weight that would not shift and poor eating habits meant mum of 4 Paula soon weighed 16st 9lb. Peter weighed 19st 6lb.

“After putting the kids to bed I often felt too tired to cook so most nights I ended up shoving a ready-meal in the microwave” says Paula “Or we’d have a takeaway and pig out on the sofa with a DVD. We dieted. I’d always lose a few pounds but then Peter would offer me a piece of chocolate. A piece would become a whole bar and I’d think ’sod it’ and go back to my old ways.” 

Their children also started to slip into bad habits. They hardly ever ate fruit or fresh vegetables, just frozen lasagna and chips, crisps, biscuits and fizzy drinks.

Paula hated shopping and never wanted to go out as she didn’t have anything nice to wear. And Peter admits their sex life had hit an all time low.

When Peter bumped into an old friend he hardly recognised him. He’d had gastric band surgery and had lost more than 6 stone. Peter decided there and then that this was the answer for him too.

When Peter told Paula of his decision to have a gastric band fitted, she decided that if he was, then so was she. From then on, the couple spent their evenings researching the procedure on the internet. 

After their operations they could eat only liquidised food and slowly moved on to soft and then solid foods.

Life has changed dramatically for Peter and Paula. Now they eat fresh fruit and vegetables and lean meat. They take their children cycling and swimming and Paula has had a great time shopping for jeans and fitted dresses in really bright colours And being slim has definitely boosted their sex life.

Paula says “I wanted to lose weight for years. I admit I only had the gastric band to keep up with Peter, but I’m so glad I did. Apart from having the kids, it’s the best thing we’ve ever done”  

The Mirror 29/9/09

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What a great story, with the whole family gaining the benefit of Peter and Paula’s gastric band surgery.

Time and again we hear stories from the families of our patients about how much better life is now that mum or dad have shed their excess weight.

In our experience it is not uncommon - particularly with the non surgical gastric balloon procedure – for people to come along 2 or 3 at a time. We’ve had mothers and daughters, husbands and wives, sisters (even twins) and friends. We’ve even had a father and son.

Orthopaedic surgeon Chris Oliver from Edinburgh was morbidly obese. He weighed over 27 stone and had become virtually immobile. Three years ago he could hardly climb a flight of stairs. This year he cycled over 1000 miles from Lands End to John O’Groats.

After unsuccessfully following several diets he realised that obesity was ruining his life and he took the decision to have a gastric band fitted early in 2007. He knew that the gastric band was a tool to help him change his life and after his procedure he lost more than 10 stone in weight and forced himself back to physical fitness.

What was his inspiration?

He said “I wanted to get fit again and be healthy but most of all after my weight loss surgery I realised that this was a second chance at life and that each day we live is so valuable”

BBC News 20/10/09

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There are many misconceptions about obesity and there is a great deal of judgement and unfair discrimination. This story shows that although their job is to promote health and well-being, people in the medical profession struggle with obesity in the same way as the rest of the population.