Introduction to Bariatric Surgery (weight loss surgery)

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What is Bariatric surgery?

Bariatric surgery or weight loss surgery is used as a treatment for people who are obese. The surgery helps you lose weight, improve health and quality of life. You may be able to reduce or stop some of your tablets and medicines. You must follow your Bariatric Teams advice to achieve good outcomes in the long term. Bariatric surgery is a major operation and is only considered if you are unable to lose weight through a healthy diet and exercise.

How does the surgery work?

Gastric Bypass

A small pouch is created at the top of your stomach, which is then connected to your small intestine. This means it takes less food to make you feel full and you’ll absorb less
nutrients and energy from the food you eat.

Gastric Sleeve

This reduces the size of your stomach to around 20% of its original size. You won’t be able to eat as much as you could before surgery and you’ll feel full sooner.

Why treat obesity?

A reduction in weight can increase life expectancy by 8 to 10 years and it may prevent or improve conditions such as Type 2 diabetes, high blood pressure, sleep apnoea, infertility and joint problems.

Who qualifies for surgery?

Bariatric surgery is available on the NHS if:

• You have a body mass index (BMI*) of 40 or more, or a BMI between 35 and 40 and an obesity-related condition that might improve if you lost weight (such as type 2 diabetes or high blood pressure).
• You’ve tried all other weight loss methods, such as dieting and exercise, but have struggled to lose weight or keep it off.
• You agree to long-term follow-up after surgery, such as making healthy lifestyle changes and attending regular check-ups.

*BMI: a measure that uses your height and weigh to work out if your weight is healthy.

Living with Bariatric Surgery

Eating and drinking

A smaller stomach means you must make changes to the way you eat and drink for the rest of your life. You start with puree foods for 4 weeks and then gradually introduce normal textures. Within 12 weeks you will be eating 3 main meals, side plate size and 2
small snacks. You must chew your food well, eat protein foods and make time to stop and eat. You must sip fluids slowly throughout the day, not eat and drink at the same time and not drink alcohol.

Weight

It is not possible to predict how much weight you will lose. Weight loss tends to be fast in the first 4 months, about 1 stone per month. This then slows down and be stable within the year. It is unlikely that you will reach a BMI of 25 or less. The operation aims to improve your health and weight is only part of this. To achieve the best results, it is important to follow advice about long-term food and lifestyle changes.

Commitment

• You must attend clinic appointments after your surgery for 2 years.
• You will need a blood test every year.
• You must take vitamin and mineral tablets every day. You will become unwell if you don’t.
• You may have skin folds which will not be removed by the NHS.

What do I do next?

Speak to your GP if you think weight loss surgery may be an option for you. Your GP can refer you to the Bariatric Service if you meet NHS criteria. We will assess if surgery is suitable. If there are complicated medical issues surgery may not be in your best interest. Not everyone who is referred will have surgery.

References

1. Weight Loss Surgery Information and Support (WLSinfo)
2. “Living with Bariatric Surgery” book by Denise Ratcliffe
3. Drinkaware – alcohol advice
4. Quit smoking with support
5. NICE Guidelines CG189. Obesity: identification, assessment and man-agement