Bariatric
Surgery
Information Leaflet
How do you get referred for Surgery?
As you know all patients living in Plymouth requiring NHS Bariatric
Surgery have to attend the Weight Management Clinic and complete
3 months of the program prior to consideration for referral. This is to
ensure that you can make the necessary lifestyle changes required
before and after surgery which will help to make it more successful
for you. The pathway is then as follows:
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Review appointment with Nurse Specialist
Attend Pre-Assessment Group Session with Dr English,
Consultant Endocrinologist/Diabetologist
Full clinical assessment appointment with Dr English
MDT discussion between Dr English and Team.
Referral to Derriford (You will then be offered and
appointment with the Surgical Team at Derriford and preop assessment prior to your operation being performed)
Surgical Referral Criteria
BMI is over 35kg/m2 if you also have medical conditions that would
be improved by weight loss such as diabetes, high blood pressure,
high cholesterol or sleep apnoea. Without comorbilities, your BMI
needs to be over 40 kg/m2
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Completion of Initial 3 months
Non smoker
You have made serious attempts to lose weight with
other methods
You are prepared to make substantial changes to
your eating habits and lifestyle
You will need to lose 10% of your total body weight
prior to referral
How surgery works
The human body lays down fat stores if the calories in the food you
eat exceed the energy you burn up. There are a number of complex
processes which the medical profession is only just starting to
understand that seem to contribute to increasing obesity - the
appetite mechanisms go wrong and you continue to eat even though
you do not need the calories. And of course, once your body is
carrying the extra weight, it becomes harder to be physically active
which would help to regulate your weight.
Depending on your individual weight problem and health goals, the
decision as to which route you go down is made jointly between you
and the team. Briefly, there are two modes of action of weight loss
surgery:
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Restrictive operations cause weight loss by reducing the
amount of food that can go into your stomach. This makes
you feel full very quickly, removes hunger and reduces the
need to eat. The gastric band is the simplest form of obesity
surgery and works by restriction.
Operations that cause malabsorption reduce the amount of
food that can be digested by the intestine. Restriction and
malabsorption effects are combined in the gastric bypass
operation.
The amount of weight loss after surgery depends both on the type of
operation and your dietary habits. Success is measured as 'percent
of excess weight loss'. International studies show that the average
excess weight loss in the two years after a gastric band is around
50-65% and after a gastric bypass it is 65-75%. Weight losses of
these magnitudes will result in a completely changed body image
and improved quality of life. However, the amount of weight you
want to lose is just one of the many factors that make up the
decision about which operation is right for you.
BOSPA
We strongly recommend that you try and attend a BOSPA meeting.
The British Obesity Surgery Patients Association (BOSPA) has
monthly meetings where you can meet others who are going to have
surgery or who have already had their operations. You will be able to
talk to others to ‘find out what it’s really like’. All patients who have
attended have found this very useful and supportive. You can visit
their website at www.bospa.org for more info.
BOSPA South Devon / North Cornwall Saltash
Meeting location: Ashe Torre Hall, Old Ferry Road, Saltash, and
Cornwall PL12 4GT (on the riverside underneath the Tamar Bridge
opposite "The Boatman" pub)
Meeting frequency: Second Sunday of every month from 2.00 to
4.30pm.