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Weight Management The Fitzwilliam Hospital is one of Cambridgeshire’s leading private hospitals, with an excellent reputation for delivering high quality healthcare treatments and services
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he Fitzwilliam has been offering bariatric programmes and weight loss procedures successfully for many years, and offers a range of surgical and non-surgical treatments backed up by a very thorough on-going programme. Background People become overweight because they are consuming more calories than they use up through exercise and everyday life. These extra calories are stored in our body as fat so they can be used up later - but people who consume more calories than they use up each day will gradually put on weight. As our lifestyles have become less active and fewer people do physically demanding jobs, being overweight has become more common. Many overweight people will find it difficult to exercise or even to move around normally - which will further reduce the amount of calories they use up. And many people with weight problems find it difficult to control their appetite - the normal mechanisms which will tell them they are ‘full’ after a meal may malfunction and they may continue to eat. In the long term, increased weight can damage your health contributing to everything from infertility to type II diabetes. It can also affect people’s self-confidence and self-esteem. Many people are advised to lose weight by their GP but find this difficult, even if they diet or try to exercise more. If they become seriously overweight then, over time, this will increase the risk that they suffer from diseases linked to weight. Weight Loss Surgery Weight loss surgery can help many people but it is not recommended for every one. It is a lifelong - and often life-changing - decision and is not designed for people who are just a few pounds overweight or who want to look better for
their summer holiday! Your GP may recommend you try to adjust your diet and exercise and possibly try a drug which can help with weight loss. Weight loss surgery helps you to lose weight by either cutting your intake of food or preventing some of what you eat being absorbed. It is normally used in patients who are significantly overweight (with a body mass index (BMI) of 40 kg/m2 or over) and who have tried other methods to lose weight without enough success. Mr Tsang, a Peterboroughbased consultant with a specialist interest in this area, says: “Weight loss surgery should be looked at as a last resort; and to be effective, it still needs to be combined with an effective weight loss programme.” There are four main procedures offered at the Fitzwilliam: Laparoscopic adjustable gastric banding In this procedure a constricting ring is placed around the stomach and may be secured with stitches. This slows the passage of food through the upper part of the stomach and can create a sensation of fullness, even if only a small amount of food has been eaten. This type of procedure is known as restrictive because it reduces the amount of food you eat, thereby decreasing calorie intake. Gastric banding using keyhole surgery techniques (laparoscopic) and is a less invasive procedure than some other weight loss surgery. It results in on average 40% of excess weight lost. Sleeve Gastrectomy This is a more radical restrictive technique and involves removing part of the stomach. A sleeve-shaped portion of the stomach is left which reduces the patient’s capacity to eat food. But the part removed also contains cells which secrete a hormone which is thought to produce a feeling of hunger - so removal may also make you feel less hungry. Obviously, this procedure can’t be reversed and your surgeon will consider very carefully whether you are suitable for it and how much stomach to remove. A sleeve gastronomy will sharply reduce your calorie intake - you can eat normally but will want much smaller portions - and can lead to on average 5060% of excess weight lost. Gastric bypass This procedure involves food bypassing parts of your intestine which means that less is absorbed from it - thereby reducing
calorie intake. In addition, the size of the stomach is reduced creating a full feeling. So your food intake is both restricted and the amount of calories you can extract from it is reduced because it is not passing through the entire length of your intestine. This means that a bypass can be a very effective way to lose weight. This results in on average 7585% of excess weight lost, because it reduces the amount you can absorb as well as being restrictive. Mr Tsang commented: “It also tends to have an almost immediate influence on hormone, sugar and diabetes, for reasons we don’t yet full understand, which are potentially very beneficial.” Gastric balloon - a non-surgical approach Some patients may not want to undergo surgery - but still want something to help them to lose weight. A gastric balloon, usually inserted into the stomach for six months, can be used to ‘kick start’ weight loss while you also change your lifestyle and eating habits. This procedure involves inserting a deflated balloon into your stomach and filling it with saline. This creates a feeling of fullness and helps you to eat less. The procedure only takes 15 minutes and you don’t need an anaesthetic, just a mild sedative. This will not result in the same weight loss as the other procedures, but may be the preferred prelude to one of the above procedures which will then have a greater chance of a positive outcome. Getting started at the Fitzwilliam Just call to make an appointment or get a referral via your GP. Initially you will speak with the specialist bariatric nurse, to review your medical history and start to consider options. The full assessment process will then be conducted by a multi-disciplinary team that includes a surgeon, bariatric nurse, dietician and anaesthetist. The Fitzwilliam has three consultants with specialist skills in bariatrics: Mr Alfred Choy MA MB BChir FRCS Mr Andrew Tsang MBBS, BSc, MRCS (Eng), MD, FRCS (Gen Surg) Mr Farrukh Bajwa MB BS • A useful source of further information is BOSPA (British Obesity Surgery Patients Association) http://bospa.waxwing.co.uk • Fitzwilliam Hospital, Milton Way, South Bretton, Peterborough, PE3 9AQ Tel: 01733 842304 www.fitzwilliamhospital.co.uk
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