Obesity Surgery FAQs

Am I obese?

If you are morbidly obese, or if you have a body mass index (BMI) between 35 and 40 and have a risk factor for an obesity-related disease, you can be considered for obesity surgery.

What is obesity surgery?

Obesity surgery is a surgical procedure for people who have tried everything to lose weight but have not been able to do so (or maintain weight loss).

What is the background to obesity surgery?

Obesity surgery can be traced back to the 1950s. Many innovations and improvements have been made since to make the procedure safer. In recent years, obesity surgery has gained increasing popularity as an alternative to weight loss diets. More and more people are turning towards this procedure to decrease their excess weight.

How can I lose weight safely?

You may feel that weight loss surgery is too drastic a measure and the risks associated with undergoing surgery are too great. We are here to reassure you that by using expert bariatric surgeons in dedicated high-tech hospitals the complications are minimised.

How is obesity surgery performed in the U.K.?

Obesity surgery is not designed as a quick solution and requires a comprehensive programme that includes the support and services of other healthcare professionals such as dieticians and psychologists over the long-term.

The surgery involves placing an adjustable gastric band (sometimes called a lap band) round the upper part of the stomach, which restricts how much food the patient can eat before feeling full. The gastric band is usually inserted using laparoscopic (keyhole) surgery. It can then be adjusted to suit the patient's weight loss or removed altogether if needed.

Gastric bypass is also an option.

How do I know if I am eligible for obesity surgery?

You may be a candidate for surgery if:

• You are 18 years of age or over
• Previous attempts at weight loss in a medically supervised programme have failed
• Your BMI is greater than 40 or between 35 and 40 with major obesity-related medical problems

How does obesity surgery work?

To put it simply, the operation manages to restrict the amount of food and drink a patient can eat or drink. It also creates the feeling of fullness faster. The weight loss process involves consuming fewer calories than the burned calories. Because the band is adjustable the feeling of fullness can be controlled.

In brief, what's involved with obesity surgery?

You will usually stay in hospital for one night following the operation. You will also be required to attend a number of post-operative consultations that will include counselling to ensure you are adapting to the lifestyle changes.

The aim of obesity surgery is to ensure the patient is able to achieve their weight loss goals and simultaneously adjust to the lifestyle changes that will be needed following insertion of the gastric band.

Does obesity surgery really work?

Obesity surgery provides a significant chance for improvement in health and well-being when it is also accompanied by a change in eating, physical activity and behavioural patterns. In other words: a change in lifestyle for the better.

What are the main benefits of obesity surgery?

The main benefits of losing weight after obesity surgery include:

• Non-insulin diabetes (type 2) may be cured (80% of the cases)
• The conditions of hyperglycaemia, hyperinsulimia and insulin resistance can be improved after performing gastric bypass
• High blood pressure is cured in 50% of the patients
• The level of cholesterol is ameliorated
• Sleep apnea can be cured (75% of the cases)
• Shortness of breath can be improved after gastric surgery
• The number and severity of asthma crises can be reduced

Other health benefits include the relief of: lower back pain, arthritis, heartburn, urinary incontinence, etc.

Needless to say, the benefits are psychological as well. Generally, patients are very self conscious of their obese appearance and get frustrated in public. By reducing their weight they may feel better about their appearance. Simultaneously, they will be more able to get access to various activities they didn't tend to do before, like swimming or going to the gym.

Is obesity surgery right for everyone?

No. Only after a complete evaluation and discussion with the patient do we determine whether he or she is right for surgery. Obesity surgery is a life-altering procedure. It is imperative that patients are committed to making the lifestyle changes needed for a successful procedure.

A consultation should occur between you and your surgeon before the day of surgery. You should ask your doctor to provide you with information related to: benefits, risks, various surgical techniques, qualification and others.

It is recommended that you look at before and after photos, discuss with other patients and get answers from your surgeon.

What are the risks of obesity surgery?

All surgeries come with the possibility of complications, but fortunately their incidence is quite small. There is even a slight risk of death from the complications that may appear after obesity surgery but this is extremely rare.

The post-operative health risks of restrictive weight loss surgeries like gastric banding include:

• Slippage of the band -This and other band problems can be corrected surgically if diagnosed early.
• Food intolerances - In certain cases, food intolerances or even perforation of the stomach may lead to the band removal.
• Internal bleeding and blood clots -There is a 1% chance of blood clots occurring in the legs after surgery.
• Infections -There is a small risk of infection in the incision area if the procedure is open and the laparoscope is not used.
• Pulmonary problems
• Heart attack
• Vomiting -The vomiting may develop when the small stomach pouch is stretched by food particles that have not been chewed well.
• Hernia - In 10-20% of the cases, abdominal hernia may occur. It can be caused by vomiting or straining after surgery usually before the incision heals. Laparoscopy-assisted surgery greatly reduces hernia risk.

What are the risks of surgery vs. risks of obesity?

For most patients suffering from morbid obesity the big question is, do the benefits of obesity surgery outweigh the risks? The answer is ‘yes'. Severe obesity is a frequently progressive, chronic, life threatening disease. There can be no doubt that the known health risks associated with morbid obesity far outweigh the risks associated with surgery.

How much weight will I lose? Will the weight loss be quick?

It depends on which obesity surgery you have. Patients who have adjustable gastric banding procedures usually lose weight more slowly the first year than those who have gastric bypass, but total weight loss is comparable with each procedure.

You'll lose plenty of excess weight during the first year after your operation. But you'll have to change your eating and exercise patterns to ensure that weight stays off.

How long will I have to stay in the hospital after surgery?

This will depend on the type of obesity surgery you have. Generally, hospital stays are between one and three days.

What if I have excess skin?

As you start losing weight, you may notice excess skin. The amount of excess skin you experience will be due to your weight loss, age and smoking habits. However, we are able to offer a comprehensive range of body contouring procedures to help correct the problems associated with dramatic weight loss.

How long will I be off work after obesity surgery?

This will depend on the type of weight loss surgery you have. After gastric banding surgery, you can return to work in about one week. On average, the gastric bypass procedure involves a two to four week recuperation.

Can I become pregnant after obesity surgery?

Women should avoid pregnancy for at least 18 months after surgery. Please discuss any pregnancy plans with your surgeon during one of your clinic appointments.

Will I have to take vitamins?

Yes. The number depends on your weight loss procedure. The gastric bypass procedure requires a lifetime of vitamin supplementation - usually three supplements daily. A gastric band requires a multivitamin everyday.

Should I exercise after obesity surgery?

For maintaining your weight loss, regular exercise is extremely important.

What about dietary changes after obesity surgery?

Set aside three meals a day when you only eat solid foods. This will help you eat nutritious meals rather than endless snacking.

Eat slowly and chew foods until they are mushy. Also:

• Allow 30 - 60 minutes for each meal
• Aim for 30 chews for each bite, chewing thoroughly to mush
• Explain to people why you must eat slowly
• Take small bites. To make it easier to chew, cut food into the size of a pea
• Sit down and be focused on eating, not other activities where you can become distracted

Stop eating as soon as you feel full. If you eat too much you'll feel sick. Because the amount of space in your stomach is so small, do not eat and drink at the same time. When you get the feeling of fullness, stop eating, even if you have not finished your meal.

What happens if I don't follow the diet?

Obesity surgery is successful 80% of the time. The main reason it fails the other 20% of the time is because patients don't follow the post-surgery diet and exercise habits.

Find out more

If you would like to find out more about obesity surgery, or arrange a consultation, contact us today on 08707 606 555, or by completing our online enquiry form for an immediate response.