Obesity surgery is the most effective treatment for individuals with chronic weight problems who have been unable to achieve and maintain weight loss by other means. Surgery reduces health risks, improves mobility, restores self-confidence and self-esteem and improves long-term survival. In experienced hands, it is a remarkably safe form of treatment. The Private Healthcare UK Guide to obesity and obesity surgery has been provided by
Dr David Ashton who is widely recognised as one of the UK’s leading authorities on all aspects of weight loss and management of the post surgery patient. Dr Ashton is Medical Director of
Healthier Weight Centres the UK’s most comprehensive provider of weight management and obesity surgery programmes.
What types of obesity surgery are there?
The surgical treatment of obesity has been transformed during the last decade or so, largely due to developments in laparoscopic (keyhole) techniques and anaesthetics. Two types of surgical procedures used to promote weight loss are:
Restrictive surgery During these procedures the stomach is made smaller so that it holds less food, making you feel full with smaller portions. Because you can only eat small quantities, your calorie intake falls and you lose weight. Restrictive procedures do not interfere with normal digestion and absorption of nutrients.
Malabsorptive surgery These change the body’s ability to absorb calories from food. By re-routing food in such a way as to exclude (bypass) a section of the small bowel (intestine), much of the calories and nutrients pass through without being absorbed. Again, fewer absorbed calories means weight loss.
Most modern surgical treatments for obesity involve pure restriction or a combination of restriction and malabsorption. The two most commonly performed operations for obesity are:
and
Gastric banding is a purely restrictive procedure whilst gastric bypass combines restriction with a small malabsorptive component. Other less commonly performed procedures include biliopancreatic diversion (BPD), duodenal switch (BPD/DS) and variants.
A summary of the main benefits and risks of these two procedures is shown below:
TABLE 1 Laparoscopic Adjustable Gastric Banding versus Gastric Bypass |
Laparoscopic adjustable gastric banding (LAGB) | Gastric bypass |
100% restrictive procedure | 70% restrictive, 30% malabsorptive |
Takes around 45 minutes | Takes around 1.5 – 2 hours |
Hospital stay 1 night | Hospital stay 3 nights |
Recovery time 10-14 days | Recovery time up to 6 weeks |
Fully reversible procedure | Not easily reversible |
50-60% excess weight loss | 60-70% excess weight loss |
<5% early complication rate | 5-10% early complication rate (haemorrhage, staple-line leakage etc) |
Mortality 1: 1000 (0.1%) | Mortality 1:200 (0.5%) |
No risk of metabolic complications | Risk of metabolic complications including vitamin and mineral deficiency |
Vitamin and mineral supplementation recommended but not essential | Lifelong vitamin and mineral supplementation essential |
Regular band adjustments required to achieve desired weight loss | Regular blood tests required to prevent anaemia, protein deficiency etc |
Healthier Weight Centres’ expert team will advise you regarding which of these procedures – or other alternatives – is the most appropriate for you.
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