Spire Washington Hospital provides a comprehensive weight loss surgery service. Here, consultant Mr Peter Small, who recently featured in the TV programme Weight Loss Ward, explains the procedures on offer and the difference they can make to patients’ lives.
Weight loss surgery is on the increase – what is causing this trend?
Around 10,000 people a year have weight loss surgery either privately or through the NHS. We know the general population is getting fatter. It’s predicted 50% or more will be obese by 2050. The basic reason for this has never changed – people eat more than they’re burning; it’s easy to get food and we snack.
Bariatric surgery didn’t really exist until about the year 2000 when we saw the introduction of laparoscopic (keyhole) surgery, which made operations much more accessible to all, particularly the overweight.
There was a 2% chance of dying during bariatric surgery but that is now just 0.1%. It is one of the safest operations in the UK and there are very few complications. Take up reflects this and the fact the number of consultant surgeons has also grown.
What are the most popular procedures and who are they most appropriate for?
At Spire Washington Hospital, we carry out gastric bypasses, gastric sleeves or put in gastric balloons. Gastric bands are also on offer but are a much less popular option today.
An initial assessment is required to identify which one is best for a particular individual. Some people eat large meals and need to reduce the volume, others are grazers who eat a lots of sweets. Medical history plays a key part in the decision, but age is not normally a factor.
I sit down with the individual and ask what they want to get out of it. If they are 30 or 40, we can try to extend their life expectancy. If they are 70, it may be that the person needs to lose weight in order to access surgery for other issues, such as arthritis in their hips and knees. Excess weight can exempt people from a lot of procedures.
You recently appeared on Weight Loss Ward, what key issues was the programme able to address?
Weight Loss Ward illustrates some of the issues we have as a nation with obesity. It follows patients in Sunderland and looks at the surgical options available.
This second series revisits patients who have already been filmed to see how they have been progressing. It’s very useful because weight loss doesn’t start and end with surgery; behavioural change is a pre-requisite to success and it is critical anyone thinking about a procedure understands this. For example, the mental desire of people to snack can quickly reverse the effects of surgery – an individual has to be totally committed to their new eating plan.
The programme is very good at showing the pros and cons. Potential complications are always part of the discussions, as are the many health benefits. For example issues with blood pressure, diabetes and joint pain can often be significantly reduced, if not resolved.
What should people always consider when thinking about weight loss surgery?
The key thing is to speak to your GP and keep them involved throughout, wherever treatment takes place.
People go for ‘bariatric tourism’ – they have a band put in abroad and go back to their GP and say "I’ve had a band put in". It is critical the GP is fully informed so the best follow on care can take place to reduce risk. There are different types of bands with different fill volumes and a doctor or nurse needs to know what the maximum is and how to adjust each different type.
Surgery really is a last resort. It should only be considered an option when someone has been unsuccessfully trying to lose weight through exercise classes, speaking to dieticians through their GP or using weight loss tablets. People must be ruthlessly honest with themselves about why they are big. If someone is comfort eating they need to understand why so they can stop.
What can people do to achieve a healthier lifestyle and what are the benefits?
After surgery, you will have a healthier life. Your weight should come down, enabling you to be more active and socialise more. Other medical issues often reduce or are cancelled out altogether.
The key to a healthy lifestyle is everything in moderation. A varied diet full of fresh fruit and vegetables is the ideal, as is regular exercise. Start small and build it up if you have to – the results will be well worth it in the end.