September 2nd, 2010
The NHS has experienced a ten-fold rise in the number of patients in England receiving gastric band surgery.
The British Medical Journal reports surgery such as gastric band and gastric bypass rose from 238 in 2000 to 2,543 in 2007. The National Institute for Health and Clinical Excellence recommended in 2002 that ‘morbidly obese’ people should be considered for surgery if other weight loss methods had failed.
Gastric banding reduces the size of the stomach by placing a restrictive band around it and gastric bypass re-routes food to a surgically created pouch.
Research was carried out between April 2000 and March 2008. The research team found that demand for weight loss surgery grew as more patients became aware of gastric band/gastric bypass.
Peter Sedman, a spokesman for the Royal College of Surgeons said “The number of morbidly obese patients in the UK is rising rapidly and we need to put more resources into this cost effective method of treatment. Otherwise, the burden on the NHS from obesity-related illnesses will be overwhelming.”
Health minister Paul Burstow said people should be encouraged to eat more fruit and vegetables, reduce the amount of fatty food in their diet and exercise more.
A spokesman for the Department of Health added “Guidance on obesity from NICE recommends that drugs and surgery should only be used as a last resort and diet and exercise should be tried first.”
BBC Health News
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The gastric band is an extremely useful weight loss aid, especially for people with a significant history of yo-yo dieting. It’s all very well to say ‘eat more fruit and vegetables’ and ‘exercise more’ but for some people this is not the answer. As the gastric band and gastric balloon are becoming better known there is an increase in demand for these procedures. How will the NHS cope and what will be the outcome? At the moment – who knows?
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August 23rd, 2010
Gastric banding is in high demand in the US and currently the procedure is legally approved for obese adults 18 years of age or older.
The Food and Drug Administration (FDA) is considering lowering the legal age for gastric banding to 14 years.
A clinical trial published earlier this year in the Journal of the American Medical Association, found that obese adolescents having undergone gastric banding achieved a loss of 50% of their excess weight. This was a greater percentage when compared with diet and exercise alone.
A gastric band is an inflatable silicone band placed around the top portion of the stomach to create a pouch that restricts food intake. The gastric band is especially attractive for use in teens because it is reversible.
Food Consumer
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Success with the gastric band depends on the willingness of the patient to make the necessary lifestyle changes. Whilst many teens will be mature enough to take this on board, others will find it impossible.
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August 23rd, 2010
Beds that can hold patients up to 72 stone are now in place in Scotland’s NHS hospitals.
The massive outlay has been necessary to deal with Scotland’s constantly expanding weight problem. One health board has replaced all their beds with stronger models. The highest outlay was from NHS Lanarkshire with a bed replacement programme costing £1.1 million. This included 650 beds that can hold patients weighing up to 39 stone and 4 for patients weighing up to 72 stone.
The Daily Record
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How many gastric bands and stomach balloons could you provide for £1.1 million?
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August 23rd, 2010
Julia Day weighs 23 stone, has type 2 diabetes and sleep aponea but she has been turned down three times for weight loss surgery.
Because of her weight the 47 year old grandmother finds it impossible to play with her two year old grandson. Mrs Day also suffers from asthma, epilepsy and osteoarthritis of her spine and says that medication, dieting and exercise have all failed.
Her body mass index is over 50 and her GP says her health will continue to deteriorate and she will prove to be a huge drain on NHS resources.
Mrs Day feels she has been refused surgery because she is Scottish, not Welsh.
Wales Online
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We don’t think Julia has been refused a gastric band or gastric balloon because she is a Scottish lady living in Wales. She has been refused because the resources aren’t available for her. But why not invest the money in her now and give her a chance? After all, she is only 47 years old. In the long term it will cost the NHS significantly more money to deal with her declining health. She is obviously on a downward spiral which could so easily be reversed.
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August 23rd, 2010
Leading obesity surgeon Dr David Kerrigan has criticised Vanessa Feltz’s decision to go abroad for her gastric band. He urged patients thinking of following her example to proceed with caution.
He said that in the UK bariatric surgeons see a constant stream of patients who have complications after gastric band surgery abroad. He said “In most cases the complications would have been avoided if they had received the aftercare needed to ensure a safe result.”
On the face of it surgery in Europe appears to be a bit cheaper. However, once the cost of proper aftercare is added in, there is little difference. People who opt for cut price surgery overseas are often unaware of how important medically supervised aftercare is.
Gastric bands are not a magic cure and patients need constant training and support to get a good result. Patients who live in the UK need to be followed up in the UK. What makes matters worse is that many of those who run into trouble after gastric band surgery abroad often end up in their local NHS A&E department being treated by doctors who don’t have the specialised knowledge to deal with them.
BBC Radio 4
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We frequently receive calls from people who have had gastric band and gastric balloon procedures abroad. The ensuing problems and lack of support result in all kinds of trauma for the patient. There is also the question of medical danger to the patient who cannot be montitored in the usual way. A lot of gastric balloon patients who have had their device fitted abroad, choose not to repeat the experience, so pay to have it taken out in the UK.
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August 20th, 2010
Gastric bypass can be an effective way to lose weight but it does not guarantee that the weight will come off and stay off.
Dr Haluck, chief of bariatrics at Penn State Milton Hershey Medical Centre says “It’s a powerful tool if patients learn to eat properly. There is a short period of time where the appetite is severely restricted and they have to change to a healthy eating style during the first months.”
Dr DiMarco, director of bariatric surgery for Pinnacle Health System in Harrisburg says “After gastric bypass surgery, patients have a stomach pouch the size of a golf ball, but it can stretch as people eat larger volumes of food. People feel great in the first year as they are losing weight. Then they begin to eat a little more and to eat the wrong types of food, and they start to regain weight.”
Dr Haluck says that “In some cases the patient regains weight after the gastrointestinal hormones that change after surgery begin to normalise.”
Dr DiMarco says “Many patients who regain their weight after gastric bypass surgery don’t want to come back because they don’t want to face the reality that they’ve failed again. It can be emotionally difficult for them.”
Pennlive
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If these doctors know there is a likelihood that a large number of gastric bypass patients will regain their weight, why are they putting people through this operation? Why not give them a gastric band in the first place? Gastric band surgery won’t guarantee that the patient will not regain weight after a period of time, but it is easily adjusted to offer more restriction to either assist in maintaining weight loss or so weight can be lost again.
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August 16th, 2010
Dr David Haslam from ESCO has warned that the wrong people are getting NHS obesity surgery. Bariatric surgery is cost effective due to reduced drug costs and future hospital admissions. According to the National Institute of Clinical Excellence (NICE) there are over a million severely and morbidly obese people in the UK. Of these 230,000 people are eligible and willing to have weight loss surgery.
This year fewer than 2% of these people will receive surgery.
Relatively few surgeons perform laparoscopic surgery such as gastric banding. With a substantial financial outlay, surgery should be offered to those who will benefit most.
NICE guidelines state that surgery is appropriate for anyone with a BMI (Body Mass Index) over 40 or a BMI over 35 if other medical conditions are present. However, administrators rather than clinicians are rationing access to surgery and they are discriminating against deserving patients and promoting surgery for the wrong people.
It is inevitable that weight loss surgery is rationed but it should go to those who will benefit most. High risk patients who have an excessively high BMI and chronic health complaints will not benefit as much as patients who have a lower BMI and will gain from being physically active.
BBC News
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It is unfortunate that such a small number of people can access treatment via the NHS. If gastric bands could be offered to anyone with a BMI over 40, the growth in the obesity epidemic would slow down. We still can’t understand why the NHS does not provide the gastric balloon as a more cost effective alternative.
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August 12th, 2010
As America’s waistlines expand so does the demand for weight loss by gastric banding. The question now is whether gastric band surgery is right for teens as well as adults?
The 30-60 minute procedure can trigger significant weight loss and is reversible. It is considered to be a less invasive alternative to the gastric bypass. The surgery is approved for adults but many teens already get it on an ’off label’ basis.
There is little doubt that the surgery is effective. According to ABC News teens who underwent gastric band surgery lost 10 times more weight than teens who embarked on a regime of diet and exercise. But data from an ongoing study suggests that gastric bands are less effective for teens than adults.
CBS News
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The gastric band is a medical device, not a magical device. In other words, the gastric band will aid the patient but it will not do all of the work. Success with the gastric band depends on patient compliance. Some teens will be mature enough to work with it but others will not. At the National Obesity Surgery Centre we consider patients over the age of 16 years for a gastric balloon but you must be over 18 years for a gastric band.
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August 12th, 2010
One in four adults in the UK are classified as obese and this is costing the NHS £500 million a year.
A gastric band limits the amount a person can eat by restricting the stomach. Regular follow up with a range of health professionals is recommended for two years. Psychological counselling should be offered to patients along with a full discussion of the risks involved.
Celebrities who have had the surgery include Fern Britton, Sharon Osbourne and Vanessa Feltz.
The Daily Record
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This article makes it sound as if the NHS are spending £500m on gastric bands. They are not. The gastric band and gastric balloon can only account for a tiny percentage of this.
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July 22nd, 2010
Sharon Mevsimler was given a gastric bypass operation in 2008 and had lost weight. After gaining her weight back she has been fitted with a gastric band. The 40 year old is five feet tall and weighs between 40 and 45 stone.
Her weight puts so much pressure on her heart and lungs she is permanently hooked up to an oxygen tank to help her breathe. She is receiving round-the-clock care after becoming the biggest person ever to be fitted with a gastric band.
Total Essex
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This is such a sad story. So many people regain weight after gastric bypass surgery. It’s a shame she wasn’t given a gastric band in the first place but there is no guarantee that this will work for her either. Unless she is willing to comply with the advice she is given and alter her eating habits to accommodate her band, she is likely to fail.
Note on 11th August 2010
Sadly, after we included this article, Sharon died in hospital.
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