Obesity Surgery

Obesity SurgeryThe terms Obesity (or Bariatric) surgery, relates to operations which are performed to specifically to assist patients who are deemed clinically obese and require a reduction in weight for both health and lifestyle reasons.

The Facts

Our westernized world of stressful jobs, limited time and unhealthy eating has lead to over 60% of the US population and more than 50% of Western European population being clinically obese. Obesity is deemed, after smoking, to be the leading cause of preventable death.

With many medical advances and easy access to medical advice, effective treatment of obesity is not only easy but has a greater health benefit to the population of the world than any other treatment available.

Statistics show that 25% of the UK adult population are estimated to be severely overweight (have a BMI (Body Mass Index) >30). The World Health Organisation classifies anyone with a BMI greater than 25 as overweight and a BMI greater than 30 as obese.

What are the risks of being obese?

People who are deemed clinically obese are much more at risk of developing co-morbid diseases which would worsen if the BMI rises but often improve dramatically with weight loss/lifestyle changes. More commonly associated with clinically obese people are diseases such as Impaired Glucose tolerance which leads to Type II diabetes, hypertension (high blood pressure), cardiac trouble and cancer.

There are many other associated diseases – for women, infertility and pregnancy complications are a risk. Impaired mobility and arthritis are also commonly seen. Along with the physical effects, psychological health can also be dramatically affected, with depression, low self esteem and reduced self confidence being common.

At the British Surgical Clinic, we provide a comprehensive team approach to weight loss. Most patients fail to lose weight because they lack support and have no guidance in their attempts to lose weight. It has been repeatedly shown that patients who attempt weight loss within the safety of an experienced and dedicated multidisciplinary team are much more successful than patients who simply try diets, weight loss drugs or have surgery without expert long term follow up and monitoring.

Non-Surgical Treatment Options

There are a variety of options available to assist you in weight loss and many of these are less serious than surgery. For those with a BMI of 25-35, lifestyle changes can assist with weight loss of around 10kg. These can include change in eating habits, exercise programmes, some pharmacological agents (which should only be taken with the advice and guidance of a suitably qualified person) and behaviour modification.

Our specialist weight loss team offer ongoing support and diet modification programmes, specifically designed to meet each individual patient’s needs

Surgical Options for Weight Loss

Broadly speaking there are two types of surgery which can be offered to help people loose weight.

  1. Restrictive surgery (BIB Intra-gastric balloon and Laparoscopic Band (LapBAND).
  2. Malabsortive surgery (Gastric By Pass, Duodenal Switch or Sleeve Gastrectomy)

At the British Surgical Clinic, we offer Restrictive Bariatric surgical options only. Patients who require malabsorption surgery are referred on to our collaborative surgical teams either on the Costa del Sol or the United Kingdom (depending on patient choice).

Restrictive Obesity / Bariatric Surgery

Intra Gastric Balloon

The BIB® intra gastric balloon is a useful tool which enables people with a BMI between 25 and 30 to lose weight without resorting to surgery. The technique involves the insertion of a silicone balloon into the stomach which is filled with up to 700ml of saline. This is then left in the stomach for up to 6 months during which time it restricts the amount of food that can be ingested and thus controls calorie intake.

As with all weight loss surgical techniques, the best result is obtained if a patient is supported by an experienced dietician and undergoes training to modify their behaviour to alter their dietary habits and increase their physical activity. Our team approach offers surgical, dietary, behavioural and personal training specialists to ensure the best possible results.

Using this non-invasive device, we have found patients can lose up to 20kg in just a few months, although results do vary from patient to patient.

Laparoscopic Adjustable Gastric Band (LapBAND®)

The adjustable laparoscopic band is currently the safest and least complex surgical option for weight loss. It involves the placement of a silicone band (which contains a small balloon) around the neck of the stomach. Once in place the balloon in the band can be inflated or deflated via a small device which is placed under the skin on the abdominal wall.

The British Surgical Clinic team use the named LapBAND®, which is the most popular device of this type in use today. The LapBAND® is placed in the abdomen around the neck of the stomach by way of a laparoscopic operation which lasts approximately one hour.

After the operation, patients need to follow a special liquid diet for  seven days (whilst the operative swelling around the stomach settles) following which normal food is introduced.

After six weeks the team fill the balloon to restrict dietary intake. It may take a few adjustment visits to ensure each patient’s optimum restriction, however when this point is reached, patients should lose weight at a steady and controlled rate.

As with the Intra Gastric Balloon, the best results are achieved by patients who receive regular dietary and behavioural support. If this is adhered to in addition to a personal training programme, patients can be expected to lose up to 70 80% oftheir excess body weight within 24 to 36 months post surgery. 

Malabsorptive Obesity / Bariatric Surgery

By-Pass surgery, Gastric Sleeve and Duodenal Switch

These operations involve division of the stomach and intestines and changing the natural anatomy in order to facilitate extreme mal-absorption of nutrients. As such the operation carries much more risk than the Gastric Balloon or Gastric Band.

It is our opinion that these surgical options should not be offered as first line bariatric treatment as they are associated with significant complication rates and long term nutritional deficiency problems. In some cases however, this type of surgery is the only option for effective and sustained weight loss. Should our team conclude that you are a patient who requires one of these procedures, you will be given the option of being referred to one of our preferred providers either on the Costa del Sol or in the UK.

Summary

The fundamental tenet of effective weight loss is to eat less and do more. People who are only slightly overweight can achieve this with strict dietary control, exercise regimes and close monitoring. This is the basis of much of the success achieved by self help groups such as Weight Watchers.

Restrictive surgical intervention is only of value in patients who are mentally ready to lose weight. Failure to comply with the instructions and advice provided will lead to poor results and low rates of weight loss. The techniques only work when patients are prepared to comply with the advice given surrounding the procedure. It must be remembered that the Gastric Balloon and the Gastric Balloon operations are only tools to help patients lose weight. They are not magic devices that  guarantee weight loss.

Malabsorptive weight loss surgery involves surgically dividing and rejoining the intestines and stomach in an un-natural configuration to redirect the food so that the intestines are unable to absorb it. Broadly speaking this leads to starvation which in turn is associated with possible trace element nutrient deficiencies. Whilst drastic, sometimes this type of surgery is the treatment of choice, especially in patients whose mental state precludes them from modifying their dietary behavioural habits.

Our multidisciplinary team provides surgical, medical and dietary expertise in the assessment of an individual’s needs and likely response to dietary modification and / or surgical intervention. Each patient is fully assessed and recommendations made as to the most appropriate treatment programme to suit the patient’s needs.

Book Your Consultation Today

For more information on this procedure, enquire online today or call us in Spain on +34 951 703 243, or in Gibraltar on +350 200 49999. You can also contact us through our online form, or email us direct at info@britishsurgicalclinic.com.


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