Introduction 

Weight loss surgery, also called bariatric surgery, is used as a last resort to treat people who are dangerously obese (carrying an abnormally excessive amount of body fat).

This type of surgery is only available on the NHS to treat people with potentially life-threatening obesity when other treatments, such as lifestyle changes, haven't worked.

Potentially life-threatening obesity is defined as:

  • having a body mass index (BMI) of 40 or above
  • having a BMI of 35 or above and having another serious health condition that could be improved if you lose weight, such as type 2 diabetes or high blood pressure

For people who meet the above criteria, weight loss surgery has proved to be effective in significantly and quickly reducing excess body fat. 

The National Institute for Health and Care Excellence (NICE) is currently considering lowering the threshold for weight loss surgery to a BMI of over 30 for people who have recently been diagnosed with type 2 diabetes.

However, it is always recommended that you try to lose weight through a healthy, calorie-controlled diet and increased exercise before you consider weight loss surgery, as surgery carries a risk of complications and requires a significant change in lifestyle afterwards.

Due to these associated risks, most surgeons, whether they are working privately or for the NHS, would only consider a person for surgery if there was a clinical need, and not just for cosmetic reasons.

Read more about who can use weight loss surgery.

Availability of weight loss surgery

Even if you are eligible for weight loss surgery, the demand for this surgery on the NHS is currently higher than the supply in many areas of the country. Therefore, there may be a considerable waiting list.

Weight loss surgery is also available privately. Prices are around: 

  • £5,000-8,000 for gastric banding
  • £9,500-15,000 for gastric bypass surgery

An increasing number of people are seeking treatment abroad as costs for private treatment are often cheaper in other countries, but this option should be considered carefully. For more information, see planned treatment abroad.

Types of weight loss surgery

The two most widely used types of weight loss surgery are:

  • gastric band, where a band is used to reduce the size of the stomach so a smaller amount of food is required to make you feel full
  • gastric bypass, where your digestive system is re-routed past most of your stomach so you digest less food and it takes much less food to make you feel full

Several other surgical techniques may be recommended in certain circumstances.

Read more about how weight loss surgery is performed.

Life after weight loss surgery

Weight loss surgery can achieve often impressive results in the amount of weight lost, but it should not be seen as a magic cure for obesity.

People who have had weight loss surgery will need to stick to a rigorous and lifelong plan afterwards to avoid putting weight back on or long-term complications.

This plan will include:

  • a carefully controlled diet
  • regular exercise

The rapid weight loss may cause relationship problems, for example with a partner who is also obese, and it may lead to unwanted loose folds of skin, which may need further surgery to correct.

Also, many people with mental health problems, such as depression or anxiety, find that these problems do not automatically improve because they have lost weight.

It is important to have realistic expectations about what life after weight loss surgery will be like.

Read more about life after weight loss surgery.

Risks

As with all types of surgery, weight loss surgery carries the risk of complications, some of which are serious and potentially fatal, such as:

A 2014 American review of over 157,000 patients found the overall risk of death, within 30 days of having any kind of weight loss surgery, is around 1 in 1000. The risk of death after having a gastric bypass was slightly higher.

However, certain risk factors, such as high blood pressure or a BMI of 50 or above, increase the risk of complications.

Read more about risks of weight loss surgery.

Results

As long as a person is willing and able to stick to their agreed plan afterwards, surgery can effectively reduce their weight and treat conditions associated with obesity, such as diabetes.

Recent research carried out in America found that on average:

  • people with a gastric band will lose around half their excess body weight
  • people with a gastric bypass will lose around two-thirds of their excess body weight

Both techniques also lead to a considerable improvement (and sometimes a complete cure) of obesity-related conditions, such as diabetes or high blood pressure.

Read more about the results of weight loss surgery.




Understanding BMI results in adults

Find out how to calculate your body mass index (BMI) and interpret the results correctly.

Media last reviewed: 04/03/2014

Next review due: 04/03/2016

Body mass index and obesity

The most widely used method of seeing if you are a healthy weight is to calculate your body mass index (BMI). This is your weight in kilograms divided by your height in metres squared:

  • If your BMI is 25-29.9, you are over the ideal weight for your height (overweight).
  • If your BMI is 30-39.9, you are obese.
  • If your BMI is over 40, you are very obese (known as morbidly obese).

BMI does not provide an accurate assessment of weight in all circumstances, such as in people who are very muscular or children going through a sudden growth spurt.

Vicky Finch

'My gastric band surgery'

Vicky talks about the changes she had to make to her diet before and after weight loss surgery, and what it's like living with a gastric band

Page last reviewed: 05/05/2013

Next review due: 05/05/2015