Surgical options to help you lose weight
Obesity is one of the biggest health problems of this generation. While exercise and healthy eating are the best forms of weight reduction, surgery is sometimes the only option, as Spire Cardiff Hospital explains ....
Irrespective of gender, being overweight is a sensitive subject. Many believe the solution is simply to tell someone to reduce their food intake and take more exercise. This is far easier said than done.
As a complex issue, many people suffer not only physically but also mentally as a result of being overweight.
Many have tried “fad” diets and commercial weight-loss programmes – but what makes some people move from yo-yo dieting to weight-loss surgery?
Dr Dev Datta, consultant physician and weight-loss specialist, explains: “Surgery for weight-loss is a very powerful tool which helps individuals lose weight and effectively reduce their risk of medical problems.
“The people I see in my clinic at Spire Cardiff Hospital and in the NHS have a complex relationship with food and often medical problems which need to be addressed.
“To ensure either a surgical or nonsurgical weight-loss programme works for patients, it requires a team of experts from a number of disciplines, including dieticians, nurse specialists, physicians and surgeons, that can address all these aspects and improve the outcome for the patient.
“Weight-loss surgery isn’t just about the surgeon who undertakes your operation but the whole multi-disciplinary team that supports the individual through their weight-loss journey. It is important that we help people make the right decision – whether this is surgery or not depends on the individual.”
NICE guidance states that surgery may be the only way to ensure prolonged weight-loss for patients with a BMI (body mass index) over 40 – or over 35 with an associated medical condition that would improve with surgery.
Until recently gastric bands have been the most popular choice, but figures show that more people are trying alternative types of surgery such as sleeve gastrectomy and gastric bypass.
Michael Nutt, upper gastro intestinal surgeon at Spire Cardiff Hospital and the Royal Gwent Hospital, has had almost 10 years’ experience of gastric band surgery.
He said: “A gastric band involves placing a silicone band around the top of the stomach, resulting in the creation of a small pouch at the top of the stomach.
“This can increase the feeling of fullness after eating a smaller amount of food, which in turn reduces hunger and may help a person to lower their overall food intake.
“If you tend to eat large portions then a gastric band may provide you with a ‘rein’ to your food consumption with the aim of preventing you from eating large meals and limiting your calorie consumption.
“In our experience, weight-loss tends to be in the region of 50% of the person’s excess weight.”
However, Mr Nutt said to achieve the expected result it is vital – more than with any other form of weightloss surgery – to have the support of a dietitian and nurse specialist.
The aim is to provide the necessary information, tailored to individual needs and based on the latest national recommendations and scientific studies. The nurse and dietician will help individuals make the correct choices when it comes to lifestyle changes. The aim of this is to ensure long-term weight-loss.
Gastric bands have the option of being adjusted via “band fills”. These
Ware used predominately when weightloss levels “plateau”. The aim of the band fills is to tighten the band and increase nerve stimulation in the stomach which tells the brain it is satisfied with the smaller portion size, allowing the patient to continue moving towards their desired weight goal.
Conversely, if a patient was to become pregnant, for example, the band can be deflated to allow the required calorie intake to be increased. Spire says gastric banding remains the safest weight-loss surgical technique and the only that is adjustable and completely reversible.
Dr Rachael Barlow and Gary Howells are dietitians at Spire Cardiff Hospital. They provide up-to-date dietary advice based on national guidelines.
Often, this requires the patient to completely change what they eat and how they view food, while also making more positive lifestyle changes.
It is important to remember that people can “cheat” on a band.
The band will not stop you consuming high-calorie liquids such as alcohol or chocolate – therefore eating large quantities of these types of food may result in less impressive weightloss.
That’s why your dietician and nurse specialist will help you address why you may feel the urge to “cheat”.
For individuals with higher BMIs, a sleeve gastrectomy or gastric bypass may be a more suitable option.
Jonathan Barry, a bariatric surgeon at Spire Cardiff Hospital and Morriston Hospital in Swansea, said: “A sleeve gastrectomy involves removing up to 80% of the stomach and usually requires only a one- or two-night stay in hospital.
“After surgery, the patient feels less hungry and an average outcome achieves about a 60% of excess weightloss and impressive results in terms of patients who have diabetes or blood pressure problems.
“Sleeve gastrectomy is rapidly becoming the commonest performed operation in the UK for morbid obesity due to its safety and excellent outcomes.”
While surgeons play an important role in the weight-loss journey, fundamentally the nurse specialist is the key to facilitating the process and acts as the patient’s advocate throughout.
Weight-loss nurse specialist Nia Jenkins is a new addition to the team at Spire Cardiff Hospital. She comes with years of experience, having worked in the field of bariatric surgery with the NHS for more than 20 years.
Nia said: “Understanding our patients is key to delivering the best care possible. Being able to support them through their weight-loss journey is essential. It’s not just the impact of losing the physical weight but the impact this can have on their family interactions and relationships.
“It is important to emphasise that this is the patient’s weight-loss pathway and not ours – we simply support and facilitate to ensure the patient can achieve a weight-loss that they are happy with.”
What other choices do patients have when it comes to weight-loss surgery?
Mr Haz Al-Momani, bariatric surgeon at Spire Cardiff Hospital and Singleton Hospital, Swansea, highlighted the differences between sleeve gastrectomy and gastric bypass.
He explained: “No surgery is riskfree. Ensuring patients have a full understanding of the types of surgery available is essential. Gastric bypass is another surgical option patients may wish to consider. It is the gold standard against which all other bariatric operations are compared.
“While the weight-loss following a gastric bypass is comparable to that following a sleeve gastrectomy, bypass surgery is more effective in controlling the blood sugars in patients with diabetes.”
As a specialist team, Spire Cardiff Hospital follows and adheres to NICE guidance on weight-loss surgery. This can be found at www.nice.org.uk/ guidance/PH53.
Spire said it would always advise patients to ensure they have access to an experienced multidisciplinary team which supports them both preand post-operatively. Patients shouldn’t be rushed into making a decision about surgery but consider all their options before deciding what’s right for them.
For more information about weight-loss surgery at Spire Cardiff Hospital, call our customer service team on 029 2054 2509.