THE SURGERY
Expert: Surgery can’t cure obesity. It should only be the very last resort
Surgery must be a last resort for patients battling obesity, according to one leading doctor.
Professor Steve Turner, an Aberdeen-based consultant in children’s health, believes “prevention is better than cure” and that must begin with adults setting a good example to children on diet and exercise.
Prof Turner, who speaks for the Royal College of Paediatrics and Child Health in Scotland, said: “From the paediatric perspective, a wise person said that childhood obesity is the response of healthy children to an unhealthy environment.
“Thirty years ago, children who were obese were more likely to come from an affluent family. Now obesity is very strongly tied to poverty.”
He accepted that for a small number of select children bariatric surgery might be the way forward but added: “Bariatric surgery needs to be kept as very much a final resort. It does not cure obesity. Bariatric surgery has a number of risks. Doing an operation, that isn’t necessarily a life or death procedure, on someone who is 150 kilos comes at a huge risk because of the patient’s obesity. People who are morbidly obese have illnesses.
“The problem with obesity is that it is an imbalance of energy in and energy out. Bariatric surgery does not solve the behaviour.
“We as a society recognise obesity is a problem. What we need to do is change societal norms. We need to accept that we don’t need to eat until we are full and that we are allowed to be hungry now and then. We as a beast, are designed to go through feast and famine. But a lot of adults and children are grazing all of the time.
“We need to accept that it is good to feel peckish now and again, because when you do your body is breaking down fat. We need to listen to our body and not constantly graze. We need to get portion sizes right. Parents need to walk the walk and talk to their children.
“If you don’t feed people they lose weight.”
A gastric sleeve works by removing a large portion of the stomach through keyhole surgery. As the capacity of the stomach is vastly reduced, it can only hold a small portion of food. Patients feel full after eating much less food and are less hungry between meals. Gastric banding involves placing a silicone band around the upper part of the stomach, decreasing its size. The band creates a small stomach pouch above it, with the rest of the stomach below. The band can be adjusted through a valve on the abdominal wall. Gastric bypass, a much more complex procedure, works by making the stomach smaller and bypassing part
of the bowels so the patient absorbs fewer calories.