Obesity shows an appetite for surgical weight loss
Obesity Surgeons may not fully understand how bariatric surgery works, but they know that it does, providing hope for an end to the UK’s rapidly growing obesity epidemic.
The current scientific thinking is that it changes the way the stomach communicates with the brain, says Shaw Somers, President of the British Obesity and Metabolic Surgery Society (BOMSS), and a private bariatric surgeon at Streamline Surgical. “The stomach is not just a dumb tube that digests stuff. In fact, it’s a complex communication centre.
“After surgery we see changed activity in the brain’s addiction centres and increased activity in its satisfaction centres. After surgery, patients find they simply don’t want to eat; that the voice that says ‘eat’ has gone.”
Latest data on the number of operations carried out to treat obesity show that in just three years, British surgeons carried out around 18,283 bariatric operations. The data shows that over three-quarters of operations were funded by the NHS.
Safe and effective
Bariatric surgery is considered a safe and effective answer to the obesity epidemic facing the UK. Survival rate for surgery is over 99.9% and within one to three days, patients can go home. This is considered all the more impressive given the increasing weight and illness of patients being sent for surgery. At the time of surgery, the average patient has an average BMI of 48.8, almost twice an adult’s ideal weight.
Over half (53.9%) of men and 41.4% of women also have a high level of co-existing obesity-related disease – usually at least three conditions each. Typical problems include type 2 diabetes and sleep apnoea, or functional impairment that is so severe that people cannot climb three flights of stairs without resting.
Yet, one year after surgery, on average, patients have lost 58.4% of their excess weight and most are enjoying greatly improved health; well over half of patients can once again climb three flights of stairs without resting and patients medicating for sleep apnoea and type 2 diabetes are able to stop all treatments.
Avoiding expensive ill-health
This has important implications for the NHS, says Mr Somers: “These conditions are seen in people in their 30s and 40s who will have decades of being ill; people with diabetes, for example, can face years of worsening health. Their health and quality of life is impaired and the cost to the public purse is very high.”
But, despite its successes, surgeons are clear that in itself bariatric surgery is not enough to secure life-long weight loss. Mr Somers says: “It isn’t a quick fix. Surgery is just a tool to help people to understand their relationship with food and that obesity is the result of this not working. The reasons why people overeat are complicated – and that’s why successful surgery is always supported by an ongoing package of care from specialists in dietetics and psychology.”