Using Body Mass Index (BMI) isn't perfect but it does give us some guidance as to the risk to your health of your weight. National guidelines in the UK recommend that weight loss surgery is an option if your BMI is more than 40 kg/m2. The BMI cut-off is lowered to 35 if you have developed some medical condition because of obesity. But, careful thought may be given to weight loss surgery even if your BMI is between 30 and 35 (especially if you have Type II diabetes or have an Asian ethnic background, for example) as the risks to your health are higher at lower BMIs. So...
- What is your BMI?
- Do you have any conditions related to your weight?
- What have you done so far to try to lose or control your weight?
Basically, there are 3 bariatric operations that we use in the United Kingdom for weight loss: band, sleeve or bypass. All of these are performed laparoscopically (by keyhole surgery).
- The Gastric Band has fallen out of favour over the last few years. It isn't associated with as good weight loss as the others, it's 'high maintenance' and needs a lot of work to get to work well and may need extra operations to keep it working properly. We are now seeing that at least 30% of bands need to be removed. I no longer recommend bands.
- The Sleeve Gastrectomy is becoming hugely popular. It has replaced the band as the go to operation for a simple surgical solution to weight loss.
- Finally, Gastric bypasses. In one form or another these operations have been around since the 1960s as they offer the most 'bang for your buck'. Low risk but high gain operations, they remain the standard that other operations are measured against but have their drawbacks so cannot be called a 'gold standard'.
Based on experience, I will evaluate your individual medical requirements and the likely effects of the different surgeries for you. I will often recommend one particular operation but will, of course, take into account your preference so that the choice of operation is a shared decision.
