Weight Loss Surgery

Choosing the right kind of bariatric surgery is important. If you are considering your weight loss surgery options, it may help to know which surgeries are generally best when you are in the following situations. However, this is a very personal choice and you will need to discuss it with your doctor in detail.

When You Have a Lot of Weight to Lose
The amount of excess weight that you need to lose will have a big influence on the kind of bariatric surgery that you have. The procedure that usually produces the biggest losses is the gastric bypass, which can help you to lose up to 70% of your extra weight in two years.

When You Have High Blood Pressure or Type 2 Diabetes
Losing weight will always help to reduce the symptoms of obesity-related conditions, but if you are experiencing severe symptoms you may need to lose weight as quickly as possible. The gastric bypass usually produces the quickest results, with symptoms improving within days of the surgery.

When You Want a Reversible Procedure
Weight loss surgery won’t usually be reversed unless there is a medical reason to put you through another operation. However, if you just want to know that the possibility of reversal is there, you might want to choose gastric band surgery. A gastric bypass can sometimes be reversed too, but gastric sleeve surgery is irreversible.

If You Have a Sweet Tooth
Choosing a gastric bypass could help you to overcome your weakness for sugar. After the procedure, eating sweet foods may become less enjoyable as you are likely to experience dumping syndrome. If you eat too much sugar, you will feel sick, which should make dessert a bit less appealing.

If You Always Feel Hungry When You Diet
Each of the weight loss surgery options can help you to stick to your diet, but the one that will have the biggest impact on your appetite is the sleeve gastrectomy. This procedure will reduce the production of appetite stimulating hormones, so you should feel less hungry.

If You Want a Quick Recovery
Weight loss surgery is always a serious procedure, but the recovery time is shorter for gastric band surgery. You won’t need to spend more than a night in hospital and you will be fully recovered in one to two weeks.

When You Want the Least Invasive Option
The reason why recovering from gastric band surgery takes less time is that the procedure is less invasive. If you want to have the smallest and quickest operation for weight loss, the gastric band could be the right choice. Although the risk of complications is low for all of the weight loss surgery options, the gastric band procedure is also considered to be the safest.

Mr Agrawal offers three surgical treatments for weight loss, which are a lap band, gastric bypass and sleeve gastrectomy, so knowing how each procedure helps you to lose weight will help you decide which type of surgery is right for you. Firstly, a laparoscopic adjustable gastric band creates a smaller stomach when in place, which reduces the volume of food you are able to eat. As the band is adjustable, it is possible to alter the size of your new stomach pouch, which can aid further weight loss. Alternatively, gastric bypass surgery re-routes the course your food takes so that it misses out a portion of your stomach and intestines. The result is that you feel full quickly, which limits your dietary intake, and what you do eat is only partially absorbed, reducing your uptake of calories. Meanwhile, a gastric sleeve cuts away a portion of your stomach to create a thin tube, which again reduces the amount you can eat.

While both a gastric bypass and sleeve gastrectomy are permanent forms of weight loss surgery, it is possible to reverse gastric banding by removing the band. It is particularly important to consider the permanence of surgery with a gastric bypass, as undergoing this procedure has long-term nutritional implications, which require you to take a vitamin and mineral supplement each day for the rest of your life to prevent micronutrient deficiencies. You should also take into account the varying risks and complications of each procedure when making your decision.

To check that a surgical treatment option is suitable for you, you will receive both a physical and psychological assessment to look for any problems that may rule out surgery. Besides these assessments, you will also receive input from a specialist dietician to review your current eating patterns and check that you understand the dietary implications of weight loss surgery, which requires you to make lifelong changes to your food choices and portion sizes. The dietician will additionally give advice on a low-calorie diet to aid weight loss before you have your operation, as this helps to lower the risk that surgery poses. In the fortnight before the procedure you may need to follow a diet designed to shrink your liver to aid surgical access to your stomach and intestines and guidance will be offered on this as needed.

The procedure itself will be carried out by your bariatric surgeon at a private hospital in London. You will need to avoid eating for a while before the operation and your doctor may provide some other instructions on how to prepare. Weight loss surgery is carried out under a general anaesthetic, so you won’t be aware of anything during the operation. What happens during the surgery will depend on the kind of procedure you are having. If you are having gastric band surgery, the band will be fitted around your stomach. An injection port will also be placed under your skin so that the band can be inflated with saline. If you are having a gastric bypass, your digestive system will be rerouted so that food travels from the upper part of your stomach directly into the lower part of your small intestine. If you are having a sleeve gastrectomy, a portion of your stomach will be removed, leaving you with just a small pouch. These operations are usually performed laparoscopically. Laparoscopic or keyhole surgery is usually done through a set of small incisions rather than by opening up a large incision in your abdomen. This can reduce the risk of infections and other complications. It will also make your recovery time a bit shorter.

A degree of pain is normal after laparoscopic surgery and you will receive painkillers to help manage your discomfort. Steps will also be taken to minimise your risk of a blood clot, which may include wearing compression stockings, taking blood-thinning drugs and getting mobile as soon as possible. Guidance will additionally be given on suitable foods to eat after the procedure, as you will initially need to follow a liquid diet and gradually progress to solid foods. Although you may be able to go home the same day as a gastric band operation, with a gastric bypass or gastric sleeve you will usually need to spend two nights in hospital, but you can expect to be back working within three weeks. Once you have recovered from the operation, you should feel like your normal self again. You will be able to go about your usual routine, although you will need to be careful about what you eat.

Besides making dietary changes in the first six weeks after surgery to aid healing, your dietician will recommend a suitable eating plan for the long-term to aid effective weight loss. Keeping physically active will also help to enhance the results of weight loss surgery. It is essential that in addition to making lifestyle changes you attend all follow-up appointments to check on your recovery and progress so that any extra advice or adjustments can be made. Following your doctor’s instructions after the surgery will help you to stay well and to achieve your weight loss goals.

To find out more about bariatric surgery, phone for an appointment with Mr Agrawal today.

Weight loss surgery has helped many people. Surgery can make it easier to lose weight. However, it isn't right for everybody. Some people aren’t eligible for surgery. Others might not benefit from it. Your doctor can help you make the right choice. You should consider the following criteria.

1. Previous Weight Loss
Bariatric surgery can help you lose weight. However, surgery is a big step. You should only take it if you are sure it will help. The surgery won't do all the hard work for you. You will need to stick to a long-term diet. If you can’t, you won't lose weight. You should also consider whether you really need surgery. You might be able to reach a healthy weight without it. Your doctor can advise you on diet and exercise. You should follow this advice for at least six months. The doctor will monitor your progress. You can then have surgery if it is needed. You might not need to wait this long. You might get surgery sooner if you need to lose weight urgently. This will only happen for health reasons. Six months can seem like a long time. However, you need to be committed. You need to make lifelong changes. You will need to keep the weight off once it is gone.

2. Your Weight
Weight loss surgery isn't worth it unless you have a lot to lose. You will usually need a BMI of at least 40. You might be able to have surgery with a lower BMI. However, this is only if your health is suffering. Some conditions are caused by obesity. Their symptoms can be worse when you are overweight. They can be improved by losing weight. Examples include type 2 diabetes and heart disease. Surgery can help these conditions even if your BMI is under 40.

3. Your Health
You will need to be fit enough for surgery. However, your health doesn’t have to be perfect. Some conditions can be good reasons for weight loss surgery. Losing weight is more important when obesity is making you unwell. Any health problems linked to obesity can be improved. For example, losing weight can help with your cardiac health. It can also reduce your blood pressure. Weight loss can even relieve type 2 diabetes symptoms.

Surgery can still help if you are fairly healthy. You might want surgery if you are struggling to lose weight. Weight loss surgery makes it easier to diet. This should help you to reach a healthy weight. You will reach it faster than by dieting alone. Losing weight reduces the risk of heart disease. It protects against diabetes. Your fitness will improve. Losing weight can also enhance your quality of life.