OBESITY SURGERY (BARIATRIC SURGERY)

Why do something?

People who are severely overweight can run the risk of living a shorter life and experiencing a range of medical problems. Being severely overweight often also leads to social problems. The higher your BMI, the greater the risk to your health. Even losing a moderate amount of weight can make a big difference.

What can be done?

Diets, medication and work on changing our behavior and lifestyle can sometimes result in short term weight loss, but in the majority of people the weight is regained. For people who are severely overweight, this isn’t enough to make a real difference to their health. Many people find that dieting and intensive exercise are lifelong battles that they can’t win. Surgery has been proven to produce sustained weight loss and reduce risk to life.

The surgery

Obesity is now recognised as a chronic disease and is multifactorial in origin. It can also threaten health and lead to disorders such as diabetes, high blood pressure, high cholesterol levels and sleep apnoea (see many of the associated diseases). It can result in difficulties in everyday life, particularly if it is severe such as self esteem, physical activity and social relationships.

Obesity surgery helps patients to:

  • Lose weight in a sustainable way
  • Improve disorders connected with obesity
  • Improve quality of life

However the results from surgery do rely on commitment. It all depends on you. Surgery on its own does not result in sustained weight loss. It is only an opportunity for you to change eating habits, increase physical activity and commit to lifelong follow up.

For the rest of your life you will need to:

  • Count your Calories (1,200 kcalories a day)
  • Count you Steps (10,000 steps a day)
  • Count your kilos (weekly weighing)

Experts warn being fat is worse than smoking as stats show 1 in 5 UK cancer deaths caused by obesity.

There can be problems, even a long time after the operation. Eating a healthy diet is essential and requires lifelong multivitamins.

The decision to have an operation is an important one and requires preparation. The change in your body image and the way other people relate to you can take quite a lot of adjusting to. We will work with you through to surgery providing support and information and help you to make the necessary changes to succeed.

Obesity is an epidemic

The National Institute Health in the United States recognises that most attempts at weight loss with dietary change will in the long term not succeed. They recognise a number of factors that have led to the current obesity epidemic:

There is an energy imbalance we take in more calories than we need and therefore gain weight. Even as we age we require fewer calories. This increased energy intake is associated with our sedentary lifestyles: the car is preferable to walking. We are surrounded by food choices that often contain more calories than we need; and these foods are easily obtained contributing to the term the obesogenic environment. This has seen rapid changes in the health and weight of New Zealand and other nations. New Zealand as a whole is one of the most overweight nations and this has occurred in the last forty years; too short a time for a significant change in the genes (the instructions in our cells that determine our physical traits).

Why do we become obese?

  • Energy balance
  • Inactivity
  • Obesogenic environment
  • Genes (Epigenetics)
  • Emotions
  • Age

It is essential to know as much as possible about the operation and to commit to the lifelong changes needed. You will require lifelong follow up and monitoring by your GP.

The information we provide should help you understand the different types of operations, the risks involved and the commitment you will need to make the procedure successful. It does not replace the information and the medical advice given by your health professionals.

Bariatric Surgery

Bariatric Surgery is the most effective treatment for patients with morbid obesity, defined as a Body Mass Index (BMI) of greater than or equal to 35. It is an expectation that attempts will have been made at weight loss previously.

Some people that are referred are found to have health problems representing a high risk for safe bariatric surgery, and surgery can not be offered to these people until these problems have been resolved.

Bariatric surgery acts by limiting the amount of food that gets into the body by the digestive system. The limitation of food can occur in two ways, restriction of the amount of food the stomach can hold or malabsorptive techniques that limit absorption of certain food types. These are performed under a General Anaesthetic and usually performed laparoscopically (key-hole surgery).

Restrictive procedures –sleeve gastrectomy. The size of the stomach is reduced, initially limiting the amount of food that can enter, resulting in weight loss. In the longer term, these operations work by decreasing the urge to eat and giving a feeling of fullness sooner. This is the operation we offer.

Malabsorptive procedures reduce the normal capacity of the gut to absorb nutrients.A third type of surgery is gastric bypass (Roux-en-Y). This is both a restrictive and malabsorptive procedure.

How long will I be in hospital and off work?

Time spent in hospital varies from 1-3 days depending on the type of operation and you should plan for 2 weeks off work after you leave hospital as a start.

Risks of Bariatric Surgery

All surgery has risks, especially major surgery. Any stomach operation for obesity is considered major surgery and therefore has a degree of risk associated with it. Mortality rates are less than 1 in a thousand. The most worrying complication is a leak of gastric contents leading to infection which is potentially life threatening.

Other problems that may occur as after any surgery include heart attacks; blood clots can form in the leg veins and pass to the lungs. Bleeding can occur after any surgery, but is greatest after stapling operations (1% of people will need a blood transfusion). Precautions are taken during surgery and whilst in hospital in order to help prevent these occurring. Patients may be given blood-thinning injections prior to surgery, and/or wear compression stockings during surgery and recovery to prevent blood clots forming in the leg veins. You can help reduce the risk by getting out of bed and moving about. This is encouraged as soon as possible after surgery, as is walking as much as possible in the weeks after going home.

Before the surgery

Preparation is essential and is the start of your commitment. Over some months you will be having a complete assessment of your state of health, your psychological readiness, and you will start on a weight loss programme. You mayl have tests to check on your fitness for operation.

The decision about whether to go ahead with the operation comes after the preparation phase. If the decision is that the operation can go ahead you will be given more information and a date for surgery.

If your preparation is not sufficient you may need to do more before a decision can be made. Sometimes surgery is deemed not suitable after the preparation phase. You may decide that you don’t want to go ahead with the surgery.

After the surgery

It all depends on you. The success of any obesity operation requires you to take responsibility for your eating and exercise patterns:

Adapting to the new you

Surgery and all the changes you make can be quite something to get your head around. For many people that is all positive. But for others there is significant adjustment to make which can create its own stresses. This is one of the important reasons to stay with your follow up programme in helping support you through these changes.

Eating

After the operation, the consistency of the food you eat will be different from what you are used to, starting off with only liquid food and then soft moist food. During the initial phase of “new” eating patterns and habits, there may be occasional episodes of vomiting or pain if food is eaten too quickly or if the wrong type of food is eaten.

This problem can be avoided if you:

  • Eat small amounts
  • Chew really well
  • Take your time but only eat for half an hour
  • Identify those foods causing you problems
  • Eat a varied and balanced diet
  • Make sure you eat enough protein (meat, fish, eggs, and dairy products)

Support and exercise

The support of others is extremely important to help lose weight and maintain loss following bariatric surgery. Choose appropriate physical activities: walking is enough to start and build from there. Friends and family can help you adjust to a new way of looking and feeling after weight loss surgery.

Business Hours
Mon - Fri  | 8:00 am - 5:30 pm
Sat - Sun | Closed
Address
Wakefield Specialist Medical Centre
99 Rintoul Street
Newtown
Wellington, 6021
Phone
(04) 381 8120 extn 7331
Email