Why you might need?
Bariatric surgery should only be considered once other non-surgical weight loss methods have been tried and should not be assumed to be the easy option. Whilst sustained weight loss can be a struggle for many people, surgery is a choice for those who have tried many other methods beforehand.
Bariatric surgery, commonly known as metabolic surgery, was originally an aid for weight loss. Although over the last few decades, it has been found to have major health benefits for obese patients that overthrow weight reduction alone. These procedures help mainly with the prevention of or solution to illnesses related to being overweight (co-morbidities), for example: obstructive sleep apnoea, type 2 diabetes, high blood pressure, infertility in both sexes, high cholesterol, polycystic ovarian syndrome, risks of heart attack and stroke. This type of surgery can also reduce the risks of certain cancers in later life, particularly breast, ovarian, uterine and stomach cancers.
What BMI qualifies for bariatric surgery?
NICE (national institute for care excellence) guidance declares that patients with a BMI of 35 or more with an accompanying co-morbidity such as high blood pressure, or patients with a BMI of 40 without co-morbidity, qualify for bariatric surgery. Patients with a BMI of 30+ with type 2 diabetes qualify for bariatric surgery too. Patients of an Asian ethnicity qualify at a BMI of 2.5 less than non-Asians because of their heightened risk of harm from being overweight and related co-morbidities.
What is non-surgical weight loss therapy?
We are pioneers in the treatment of obesity and have established a specialist tier 3 multi-disciplinary weight management programme preceding surgery if this is a more favourable pathway for you. In which you will be evaluated by a knowledgeable bariatric physician, dietician, psychiatrist, and exercise therapist as needed. Hormonal reasons for obesity will be ruled out through a comprehensive clinical assessment, then by hormonal blood tests as needed.
Our medical assessment will identify and treat obesity related conditions such as diabetes, thyroid problems reduced mobility, cardiac problems, high cholesterol, sleep apnoea, hypertension, fatty liver disease and joint pain. The main objective of our personalised programme is to assist you in losing and preserving weight loss through a mixture of pharmacological, psychological, dietetic, behavioural change techniques and exercise treatment plans. These plans also help surgery, if needed or chosen to be more successful in the longer term.
For safe bariatric surgery with the best results, the procedures must be delivered within the structure of a multidisciplinary team, where the surgery is just one component to a holistic approach, combining the procedure alongside psychological and dietary support. Patients must be assessed by at least a bariatric dietician, surgeon, and psychologist before the surgery and their anaesthetic risk be assessed by a bariatric trained anaesthetist.
The types of assessment are as follows:
- Surgical assessment: involves a face to face or virtual consultation with a bariatric specialist in where your weight issues, medications, surgical and medical history, allergies, and other factors are discussed, including any procedure processes. The risks and benefits are also explained.
- Dietetic assessment: is a thorough assessment conducted by a specialist dietician who will examine your weight loss expectations and help to manage these sensibly, whilst explaining your pre- and post-operative diet.
- Psychological assessment: is a holistic and detailed appointment with a clinical psychologist experienced in weight gain concerns and potential triggers contributing to a patient's excess weight. The assessment also reflects on coping strategies for during the post-surgical phase and delves into a patient’s mental history (if required).
- Medical / anaesthetic assessment: required if patients have complex past medical or anaesthetic histories or problems.
At OneWelbeck, we all work together to personalise your treatment and put together the best options for anyone considering this surgical intervention. Therefore, it is required a minimum of 3 consultations prior to surgery, a full set of blood tests and sometimes a heart tracing may also be carried out. If any of these produce a diagnosis that was not previously detected, e.g., high blood pressure, heart problems, type 2 diabetes, or gastrointestinal issues, then additional diagnostics and referral to a suitable specialist may be required.
After bariatric surgery, a close follow up is required to guarantee that you are healthy, fitter, stronger and yet lighter. All patients who have this procedure are required to take vitamin supplementation for life and after the first year, annual blood tests will be taken to ensure that routine bloods and micronutrients are kept within normal limits.
Surgery is not without its risks, so if not followed up, risks include vitamin or other deficiencies developing in the patient that can be dangerous if preventative measures are not taken.
Please note that we only offer pre-operative and post-operative care at OneWelbeck for bariatric surgery patients - the surgery itself takes place at a different facility. Please speak to your consultant for more details.