Around a quarter of adults in England have a BMI over 30, so a growing number of us are struggling with obesity(1). While non-surgical weight loss interventions help some people to successfully lose weight and keep it off in the longer term, these options are not effective for everyone. Obesity surgery can therefore offer an alternative treatment option if you have not been able to tackle your weight gain with more traditional weight loss strategies. If you are contemplating a surgical procedure for weight loss, knowing whether you are a suitable candidate for bariatric surgery and what these operations involve will help to inform your decision about whether you wish to pursue this option further.
Even if you have struggled with your weight for some time, for Mr Sanjay Agrawal to carry out surgery to aid weight loss, you must meet the criteria as set out by NICE guidelines(2). Firstly, you must be over 18, as bariatric surgery is rarely considered as a suitable treatment option for obesity among younger people. Secondly, you need a BMI over 40 to access weight loss surgery, unless you have a weight-related health problem such as raised blood pressure or diabetes, though NICE may lower this to 30 if you have a diagnosis of type 2 diabetes. It is also a requirement that you have not been able to lose a beneficial amount of weight over a six month period while following a medically supervised weight loss intervention. However, if your BMI already exceeds 50, it may be appropriate to consider obesity surgery as a treatment without evidence of previous lifestyle changes. While that is the case, everyone considered for a bariatric procedure must be committed to making lasting changes to their diet and exercise habits and willing to comply with long-term follow-up after surgery. Finally, Mt Agrawal will review your physical and mental health to check that there are no other barriers to surgical treatment and that you are physically fit to undergo a general anaesthetic.
The most common operations to promote weight loss are a gastric band and gastric bypass, though Mr Agrawal is also able to offer a newer form of surgery known as a gastric sleeve or sleeve gastrectomy. Gastric banding uses an inflatable band to reduce your stomach size, so you feel full sooner when you eat. Meanwhile, a gastric bypass also reduces the size of your stomach, but at the same time a section of your small intestines is bypassed, which reduces your appetite and prevents you absorbing as many calories. Finally, a gastric sleeve removes part of your stomach to form a tube that is long and thin, so you can only manage smaller portions. The hospital stay, recovery time, possible risks and long-term complications vary between the procedures for weight loss, so will need to take these into account when deciding which obesity surgery is best for you.
As your main goal is weight loss, you will want to know which bariatric operation offers the greatest results. While a gastric bypass enables you to lose as much as 70% of your surplus weight, compared to around 60% for a gastric sleeve and 50% for a gastric band, this needs to be weighed against its potential risks and complications(3). For instance, the risk of mortality is higher with a gastric bypass at 0.5%, while the risk is only 0.2% for a gastric sleeve and just 0.05% for a gastric band. Overall the three options for obesity surgery all carry a risk of complications of 5%, though the possible problems you may encounter vary between the different treatments. For example, with gastric banding, the problems often relate to the band either failing, slipping or eroding, which requires another procedure, though 10% of people opt to have their band removed. Alternatively, with a gastric bypass vitamin and mineral deficiencies can arise and you may develop a hernia or adhesions. Lastly, with a sleeve gastrectomy your appetite may return and you may need another operation to keep up your weight loss.
If you would like to discuss your suitability for obesity surgery with Mr Agrawal and which weight loss procedure is best suited to your needs, phone to arrange a consultation now to bring you a step closer to lasting weight loss.