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The weight loss surgery team at Spire Thames Valley Hospital on the borders of Buckinghamshire and west London have provided some answers to frequently asked questions about weight loss surgery, including questions about specific weight loss procedures including gastric banding, gastric bypass, gastric balloon and gastric sleeve.

This list is not exhaustive and your bariatric surgeon is the best person to advise you on the each of the procedures and how they would impact you.

Questions about weight loss surgery in general

How do I choose which weight loss treatment is best for me?

No one weight loss surgery is better than the other. The best one for you is the one that suits your current medical conditions, your eating patterns, your weight loss requirements and one that you can commit to. Your weight loss surgeon will give you the best possible advice during your consultation and you will be given time to consider your options and ask more questions if you are still unsure.

What is the process for weight loss surgery at Spire Thames Valley Hospital?

You will need to ask your GP for a letter of referral to the Spire Thames Valley Hospital. You will be seen first by the dietician. His report goes to the surgeon prior to your consultation with him. The surgeon will advise you regarding the different treatments and you will have plenty of time to ask questions and raise any concerns you may have. He may need time to get more information from your GP. Only when he has all the information necessary and he is sure that surgery is in your best interests will he proceed. Once the type of treatment is agreed you will be seen by the pre-assessment nurse at the Spire Thames Valley Hospital and may be placed on a special pre-surgery diet.

Will my insurance cover the procedure?

At the moment most insurance companies do not recognise weight loss procedures in their policies.

How can I pay for my treatment?

For payment advice contact our self-pay co-ordinator at Spire Thames Valley Hospital on 01753 665404 or email info@spirethamesvalley.com.

Will my current medical conditions affect my surgery?

Many people on medication undergo weight loss surgery. It is important you let the surgeon know of any treatment you are receiving to ensure that all the necessary investigations are completed before proceeding. This ensures that any risks of surgery are minimized. After surgery, it is likely that you will have to take your medication in a liquid form or crush any tablets you normally take.

How long will I need off work?

For the gastric balloon procedure you may need a day or two off work. For surgical weight loss procedures most people can return to work after two to three weeks unless they have a manual job where they may need a little longer off work.

Can I drive after surgery?

You must  check with your insurance company. DVLA policy is that you must not drive for 10 days after any operation. You must be able to perform an emergency stop safely.

Will I have unsightly scars?

The balloon procedure is non-surgical and doesn't result in scarring. If you have the keyhole surgeries you will have 5 very small scars equally spaced across your upper abdomen. Wounds should be healed within two to three weeks and will fade over time.

Will I have a lot of excess skin after surgery?

It is possible to have excess skin after weight loss. This is different for each individual. It depends on the amount of weight lost, a person’s age, their skin condition and their commitment to exercise. You can be referred to our cosmetic surgeons but this is not recommended until two years after surgery when your weight loss has stabilized.

Will I have to take medication after surgery?

You will be given advice about any supplements and medication required to support you following your surgery. However, you may be able to reduce or stop completely some of your current medication. Any medication taken pre-operatively will be discussed with you prior to your treatment. You will be monitored continually to ensure that you are fit and well and you are progressing with your weight loss.

What can I eat after surgery?

You will liaise very closely with our dieticians who will give you a specific diet plan tailored to your individual needs after your surgery. The aim of the weight loss treatments is to help individuals change their lifestyle and make healthier food choices. The treatments can help you but all require your commitment if they are to work in the long-term.

Will I be able to drink alcohol after surgery?

It is best to avoid alcohol for the first six to eight weeks of the ‘weaning’ period immediately following your surgery. There is no reason why it should be completely avoided, but alcohol should be consumed in moderation as it is high in calories. Also, following surgery you will find that you may feel intoxicated much quicker. Alcohol is absorbed into your blood stream much more rapidly as there is less food to absorb it in your stomach.

Should I exercise after surgery?

You will be encouraged to exercise gradually following surgery. It is an important part of your recovery plan and of your weight loss.

Can I still enjoy going out for a meal after surgery?

Of course! Although your treatment will affect the amount you can eat it will not prevent you from going out. You will, however, have to choose wisely from the menu.

What happens if I have a problem?

You will have regular follow-ups included in your fixed price package at Spire Thames Valley Hospital. However, if something can not wait until your next follow-up then you can call your consultant’s administration team. If you have a medical emergency you can call the Spire Thames Valley Hospital emergency helpline number which we will give you.

Frequently asked questions about gastric bands

How much weight will I lose with a gastric band?

Weight loss results following gastric band surgery vary. The national average weight loss is 50% of the excess body weight over an 18-24 month period.

Will I lose weight quickly?

Weight loss following placement of a gastric band continues for 18-24 months and is generally slower than other, more invasive, bariatric procedures. Band adjustments will be made at stages following placement in order to ensure that it stays effective and helps with individual weight loss goals.

Will my band fill hurt?

A 'fill' is carried out by inserting a needle through your skin into the port which is placed in your upper abdomen close to your rib cage. It can be uncomfortable but should not be painful.

What if I am still very hungry after the band is in place?

The placement of the band puts pressure on the nerves at the top of your stomach which sends signals to your brain to indicate that your stomach is full. Some people do experience hunger until the band is adjusted to the optimum level.

What are the potential problems after surgery?

After eating, your body will tell you if it is unhappy with the consistency and type of food that you have consumed. In terms of more serious complications, although these are unlikely, you need to be made aware of them. They are:

  • Band slippage: This can be caused by persistent vomiting and making the wrong food choices. If the band has slipped you may experience nausea and vomiting, pain and indigestion symptoms. We would arrange tests to confirm this diagnosis and the band can be deflated and either moved or removed. It is important that you follow the dietary guidelines given to you to reduce this risk.
  • Obstruction of the band: If the food you eat is too large and solid, it may be unable to pass through the band into the lower part of the stomach, causing an obstruction. If you experience pain after eating food of the wrong consistency, it may take a day or so before the symptoms settle. In this case you must take plenty of fluids to help the food to break down. Similarly, if your band is too tight, food may be unable to pass through the band into your stomach. In this case you need to contact the hospital as soon as possible to arrange to have it adjusted.
  • Pouch dilation: Increasing your portion size can stretch the stomach pouch causing a dilation. If this happens your stomach capacity will increase and the restriction you initially felt will reduce, which may mean that you start to regain weight. This will have to be investigated and resolved.
  • Erosion: In rare cases a gastric ulcer can form in the stomach on the inner side of the band. This can be caused if the band is over-inflated and it must be removed. If you experience gastric irritation, please discuss this with the bariatric specialist nurse.

Can the band be removed?

Bariatric surgery is never carried out with the intention of reversing the procedure. Band removal is only carried out when clinically necessary or when the patient requests that it be removed. Patients must make a lifelong commitment to their band to help achieve a successful outcome.

Frequently asked questions about gastric balloons

How much weight will I lose?

You can expect to lose 20-30% of your excess body weight over the 6 months that the balloon is in place.

Will I lose weight quickly?

Weight loss is slower than with other surgeries as a gastric balloon is the least invasive of the procedures and is only a temporary measure.

How long will I have to stay in hospital?

The balloon is inserted under sedation so can normally be performed as a day case requiring no overnight stay.

How long will I have to take off work?

Most people feel nauseous for a couple of days after the balloon has been inserted so allow for this when considering taking time off. There is no other medical reason for time off.

Will I have to take any medication after surgery?

You will have to take some medication while the balloon is in situ. This will be discussed with you during your consultation.

Will the balloon restrict me in any way?

Apart from feeling nauseous for a couple of days the balloon should not affect your activity level at all.

How will by diet change after surgery?

To get the best results from the balloon, adhere to the dietary advice given by the dietician at your monthly follow-up consultations.

Frequently asked questions about gastric bypass

How much weight will I lose with a gastric bypass?

The national average weight loss following a gastric bypass is 60-70% of excess body weight over a 12-18 month period. Weight loss is generally quite fast initially but will settle into a regular pattern.

Will I lose weight quickly?

Weight loss commences when the liver reducing diet is introduced prior to surgery. Post operative weight loss can be quite rapid in the first six to eight weeks but then will settle into a steady monthly reduction until around 18 months. Long term success is related directly to a patient's motivation and their commitment to following the dietary guidelines provided.

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

You will normally stay in hospital for two nights for this type of procedure. The first night you will be in our High Dependency Unit.

Will I have to take medication after surgery?

Yes. All gastric bypass patients will need to take nutritional supplements and medication to protect the stomach. Calcium, multivitamins, iron, B12, folic acid and a protein pump inhibitor will be prescribed by your GP to commence two weeks after your operation. These medications will be discussed during your consultation and pre-assessment prior to surgery.

How will my diet change after surgery?

It is vital that only liquids are consumed for the first two weeks to reduce the risk to the stitches and healing in the stomach. Then there is a need to restrict the consistency and type of foods that can be consumed in order to progress the healing and because of the presence of swelling between the opening of the new stomach pouch and the intestine. The new stomach pouch is much smaller and subsequently has a smaller capacity to store anything that you eat. This means you won't be able to eat large volumes of food. You will feel full very quickly (after only a few teaspoons initially) and your appetite should decrease. As the body adjusts and swelling settles there will be some give allowing for more solid food to be consumed.

You will not be able to eat the same volume of food as you do now. By the end of the first year you should be able to eat a child sized portion of food. This will gradually increase as your weight stabilizes and your tolerance increases.

Due to dietary restrictions, it is important to protect against nutritional deficiencies. Following surgery you should have a multivitamin, calcium and iron supplement which will protect against the risk of osteoporosis and anaemia. Occasionally a zinc deficiency may occur and you may be prescribed a further supplement. An anti-acid tablet will help to reduce stomach acid and prevent the formation of ulcers. Immediately following surgery, the body is healing, so it is important that you still consume adequate calories and protein to promote recovery.

What if I am still hungry after surgery?

Most patients experience a reduction in hunger following a gastric bypass though some patients continue to feel hungry at times. It is important to make lifestyle changes and change eating habits to best manage those symptoms. 'Head hunger' and 'stomach hunger' can be different and it is important to learn to recognise the difference at the early stages. Habit and food dependence may need to be addressed to reduce those symptoms.

What are they potential problems after surgery?

Although unlikely, the stomach could "leak" where it has been stitched. This would be evident within the first 24 hours after surgery and is the reason patients stay in the High Dependency Unit for the first night so they can be continually monitored. You may experience "dumping syndrome" if you eat the wrong type of foods after bypass surgery. The food goes straight into the small intestine and if you eat something sweet and high in calories the body may react to having this type of food "dumped" directly there. A patient may feel shivery, sweaty, tired and unwell. Symptoms last an hour or two and is a side effect which gives the patients the incentive to make sensible food choices.

Following successful weight loss surgery, some people experience thinning of the hair. This is a temporary side effect, normally occurring between three and six months after surgery. The hair does thicken up again.

You will require regular blood tests to ensure your supplements are adequate and you do not become anaemic as food is no longer fully absorbed.

Can the surgery be reversed?

No. It is vital that a lifetime commitment is made by the patient prior to proceeding to surgery.

Frequently asked questions about gastric sleeves

How much weight will I lose with a gastric sleeve?

The national average weight loss following a gastric sleeve is 60-70% of excess body weight over a 12-18 month period.

Will I lose weight quickly?

Weight loss is generally quite fast initially, more than with having a band but less than having a bypass, but will settle into a regular pattern. Long term success is related directly to a patient's motivation and their commitment to following the dietary guidelines provided.

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

You will normally stay in hospital for two nights for this type of procedure. The first night you will be in our High Dependency Unit.

How will my diet change after surgery?

It is vital that only liquids are consumed for the first two weeks to reduce the risk to the stitches healing in the stomach. Then there is a need to restrict the consistency and type of foods that can be consumed in order to progress the healing. The new stomach pouch is much smaller and subsequently has a smaller capacity to store anything that you eat. This means you won't be able to eat large volumes of food. You will feel full very quickly and your appetite should decrease. As the body adjusts and swelling settles, there will be some give allowing for more solid food to be consumed.

You will not be able to eat the same volume of food as you do now. By the end of the first year you should be able to eat a child sized portion of food. This will gradually increase as your weight stabilizes and your tolerance increases.

What if I am still very hungry after surgery?

Most patients experience a reduction in hunger following a sleeve gastrectomy though some patients continue to feel hungry at times. It is important to make lifestyle changes and change eating habits to manage those symptoms. 'Head hunger' and 'stomach hunger' can be different and it is important to learn and recognise the difference at early stages. Habit and food dependence may need to be addressed to reduce those symptoms.

What are the potential problems after surgery?

Although unlikely, the stomach could "leak" where it has been stitched. This would be evident within the first 24 hours after surgery and is the reason patients stay in the High Dependency Unit for the first night so they can be continually monitored. Following successful weight loss surgery, some people experience thinning of the hair. This is a temporary side effect, normally occurring between three and six months after surgery. The hair does thicken up again.

The problems after surgery are fewer than is you were to have a bypass as the digestive process is not changed. Food is still absorbed so there is no need to have food supplements for the rest of your life nor is there the same need to have regular blood tests.

Can the surgery be reversed?

No, a large part of the stomach has been removed. It cannot be reversed.

Frequently asked questions about the non-surgical gastric balloon (Obalon)

What is Obalon?

Obalon is a brand new weight loss treatment in the UK. This innovative treatment, which is available to those with a BMI of 27 or greater, is discreet and non-invasive and can be administered quickly and painlessly in as little as 30 minutes.

Obalon is the first swallowable gastric balloon, which once in the stomach is inflated to the size of an apple. The Obalon balloon works by making you feel fuller faster, and by following a healthy, balanced diet at the same time,  assists you in achieving the best possible weight loss results.

How is Obalon different to other weight loss procedures?

Obalon is a  customisable weight loss system, that can be tailored to meet the individual needs of patients, with up to three Obalon balloons being able to be in the stomach at one time for maximum weight reduction.

While everybody loses weight at slightly different rates, most people find that two balloons give them the best result. Your consultant will discuss this with you, and should you need fewer or indeed more balloons to optimise your weight loss, this will be discussed with you.

Once Obalon has been swallowed and has been inflated in your stomach, your brain will be sent signals that create the sensation of feeling full, faster, so reducing your food intake. Unlike older-design balloon systems, Obalon requires no anaesthetic to place - it is simply swallowed in the form of a small capsule attached to a micro-catheter. This makes the treatment easy and safe for patients and can be done as an outpatient appointment.

After the first capsule is swallowed it is left in the stomach for 30 days, after which a second balloon is swallowed if needed, a further third balloon can be swallowed after a further 30 days.  After a total of 12 weeks all balloons are removed via a short endoscopy (a telescope procedure), taking a few minutes and using light sedation if needed to remove it.

Obalon can give you a real boost to your weight loss attempt, but in order to see long lasting results, you must continue with the changes you have made to your lifestyle and dietary habits to maintain your weight loss.

You will be assessed and supported by our experienced consultant weight loss surgeons so you can be confident that you will receive expert and comprehensive advice on whether Obalon is the best weight loss option for you. If another procedure would suit your needs better, or be safer or more effective for you, we will discuss this fully with you.

What are the results?

A European trial[1] showed an average weight loss of 8kg (1 stone 3lbs) which represented 50% of excess weight.

Are there any complications?
Complications with Obalon are extremely rare. The largest study so far has been undertaken by Obalon in Europe and has shown no significant complications[2].

[1] LMR Study conducted at 11 sites in 4 countries August 2012 – December 2012
[2] Data collected and reported on the first commercial product uses at eleven centres throughout four European countries. Total sample size 119 patients.

What happens during the Obalon Weight Loss Treatment?

Obalon Weight Loss Treatment is quick and simple:

  1. You will have an initial consultation at your choice of Spire Hospital during which you will be asked to swallow a placebo capsule.
  2. If Obalon is thought to be the best treatment for you, you will return for your placement which involves swallowing the capsule that contains the balloon which is then inflated within your stomach via a micro-catheter which is removed via your mouth.
  3. After 30 days you will usually return for a second placement.
  4. Further placements are possible if required.
  5. You keep the balloon(s) in your stomach for 12 weeks.
  6. At the end of the 12 weeks, the balloon(s) is removed via a short endoscopy

Is this procedure available on the NHS?

No, Obalon treatment is only available privately.

Obalon is available exclusively with Spire Healthcare outside of Central London. Our local hospitals offer you the comfort of being near home, with free parking and fixed prices. With Spire Healthcare you will be treated by an experienced consultant at a time that suits you. You will be treated in a premium private hospital, not a clinic, and you can be assured of our commitment to healthcare standards and infection control excellence.

How many balloons will I need?

The number of balloons required is individual to your care and can range from one to three. The average number of balloons used is two.

How can I find out more?

For further information, or to book an appointment please call us and we will be happy to help on 0845 261 3694