Many gastric surgery patients pile the weight back on in the future
17th July 2012
Weight loss surgery, also called bariatric surgery, first came to public recognition around a decade ago after it was offered as a last-ditch weight loss method by government watchdog NICE, for individuals who are dangerously obese. This includes those with a body mass index (BMI) of more than 40 or those with a BMI of more than 35 and who also have a serious health condition which could be helped by weight loss such as diabetes or high blood pressure. The most common forms of weight loss surgery remain either a gastric band or a gastric bypass. The former is where a band is inserted into the stomach to reduce its size. The aim is that it will take a smaller amount of food to make you feel ‘full’. With a gastric bypass, the digestive system is diverted past most of your stomach. This then results in the digestion of less food and it takes much less food to make you feel full. By bypassing part of the small intestine, this means a reduction in how much food and nutrients are absorbed, leading to weight loss. There is currently a massive demand on the NHS for weight loss surgery operations, so much so that there is more demand up and down the country than available supply, resulting in a long waiting list. Although roughly 8,000 weight loss procedures occurred last year in England on the NHS, this is probably a small portion of the obese population. In the UK an estimated 60.8% of adults and 31.1% of children are at least classified as ‘overweight’. If somebody wanted to go private and not join the ever-growing NHS waiting list, it would set them back between £5,000 - £8,000 for a gastric band and it is even more expensive for gastric bypass surgery, usually costing between £9,500 - £15,000. However, the big question everybody is now asking – is it all worth it? Information from various studies from across the globe, expert opinions, and those who have had the procedures themselves paint a damning view of the actual benefits of weight loss surgery. If the cost alone is not off-putting, other factors could be. A Brazilian study that analysed 782 patients who had undergone weight loss surgery, found that 63% actually gained weight within two years. In addition, a German review into a collection of studies on weight loss surgery discovered that 30% of patients piled on their previously lost weight within merely 18 to 36 months. The weight gain has led to a high volume of people even requesting a second operation. One Dutch study of patients who’d had a gastric band fitted, found that approximately a third required another operation within 5 years and half needed one within 10 years. A famous figure to have had repeated weight loss surgery is Kerry Katona, who first caused controversy by undergoing £15,000 liposuction surgery in August 2008, just four months after giving birth. Althought Katona initially dropped from 12 stone to 8; by June 2009 she had piled on 2 stone of what she had lost. Then in January 2011 she paid £650 for mesosculpt treatment to get rid of the stretchmarks on her stomach. Just nine months later she had piled on another stone and in April of this year she forked out a further £8,500 for more liposuction. What people aren’t prepared for it seems is the after-life of having weight loss surgery. Many patients will struggle to adjust to the fact their stomach will not cope with the same sized portions as previously, or the fact they will have to try and adhere to a strict diet plan. Bianca Scollen, of the support group Weight Loss Surgery Info, says “In the first year, or two years, after the surgery, you feel like you’re walking on air. But three or four years on is a very different thing. In a way, losing the weight is the easy part; it’s changing your lifestyle and keeping it off that’s hard. Some people find the sight of their new, slimmer shape is enough to keep them motivated, but for others it’s not so easy.” Professor Jane Ogden, of health psychology at the University of Surrey, further comments, “Hunger isn’t just a biological process — it can be about feeling fed up and wanting comfort, or feeling bored. Unless patients have changed their attitude towards food, they end up cheating — grazing, or drinking lots of water so their stomach can manage more food.” The most worrying aspect of bariatric surgery though is that there still seems to be many health risks involved, when the main point of the surgery is to benefit the patient’s long term health. Many private companies offering weight loss procedures do not provide adequate aftercare, important in avoiding weight regain. Moreover, this leads to risk of a multitude of complications such as vomiting, infection, gastric bands slipping or leaking and intestinal blockages. According to statistics from the Medical Defence Union, there has been a doubling of negligence claims against independent bariatric surgeons between 2008 and 2010. With evidence of weight gain post-surgery, and serious health complications involved, it could be time for people to rethink their weight loss strategy!