Weight loss surgery: how to transform your health

Weight loss surgery is an excellent option for patients who are struggling with obesity, metabolic conditions or comorbid issues such as urinary incontinence and chronic back pain, as a result of being severely overweight. Surgery is a permanent solution or can majorly reduce the health risks associated with obesity.

Consultant general surgeon Mr Bart Decadt is highly-experienced when it comes to bariatric surgery. Here he explains the three commonly performed procedures: sleeve gastrectomy, gastric banding and gastric bypass, and why weight loss surgery is a great option for patients who want to increase their life expectancy and quality of life.
 

What health problems may an obese person face?

A patient may experience, or may be at risk of the following obesity-related problems:

Metabolic problems

• Type 2 diabetes
• Pre-diabetes
• Thrombosis
• Gout
• Cardiovascular risk and stroke
• Asthma
• Gallstones
• Infertility
• Cancers – breast, colon, kidney, oesophageal, ovarian and pancreas.

Mechanical problems

• Urinary incontinence
• Arthritis
• Sleep apnoea
• Chronic back pain
• Physical functioning

Mental problems

• Depression
• Anxiety
   

Can you explain the commonest procedures used?

The commonest weight loss procedures used in bariatric surgery are:

Sleeve gastrectomy

This has become the most commonly performed procedure worldwide. Up to 75% of the stomach is removed, which provides restriction of the volume of food taken and also reduces the craving between meals. This is because of the reduction of the craving hormone, ghrelin, which is produced by the stomach. The expected weight loss (EWL) is 70% of excess weight. The main complication of sleeve gastrectomy is a leak from the staple line (2%), which is reduced in my practice with routine use of staple line protection.

Gastric band

An adjustable band is fashioned just below the entrance of the stomach and is slowly filled with saline via a port located under the skin to inflate it. The complications of the procedure include band slippage, which may need to be replaced or removed. The EWL is 50% but this varies depending on the individual patient. The band does not restrict calorie-rich fluid intake (alcohol and fizzy drinks) but is still a good option in motivated patients.

Gastric bypass

During a gastric bypass, the stomach is divided and bypassed by the creation of two anastomoses. The main complications include leakage, metabolic deficiencies (such as a lifelong need of supplements), internal hernia and weight regain. EWL is 70%. However, no advantages of the gastric bypass compare to the sleeve gastrectomy.
 

Is there more to weight loss surgery than just the operation?

Before weight loss surgery, patients discuss and plan their nutrition and recovery with a surgeon, bariatric dietician and specialist nurse. Following the operation, patients are reviewed in appointments every three months across a two year period. This is to help maintain their new and significantly changed lifestyle.
 

How does bariatric surgery transform lives?

Patients often report that weight loss surgery has given them their life back. Apart from significant weight loss, it results in resolution or improvement in co-morbidities. They have a longer life expectancy and an increased quality of life. Overall it is a cost-effective and safe option.

If you are considering weight loss surgery, do not hesitate to book an appointment with a specialist for your first consultation.