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 that will not respond to non-surgical treatments, such as lifestyle changes.
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
See the box, below left, for information on how to calculate your BMI.
For people who meet the above criteria, weight loss surgery has proved to be effective in significantly and quickly reducing the amount of excess body fat (see Weight loss surgery - how it works).
However, the first treatment to consider for anyone who is obese is losing weight. This can be achieved through a healthy, calorie-controlled diet and increased exercise. It is always recommended that you try to lose weight this way before you consider weight loss surgery, as surgery carries a risk of complications and requires a significant change in lifestyle afterwards.
Because of the risks associated with weight loss surgery, 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.
For more information, see Weight loss surgery - who can use it.
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.
In total, 4,211 weight loss procedures were carried out on the NHS in April 2008 to April 2009.
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.
For more information, see Weight loss surgery - how it 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 that can occur after weight loss surgery may cause relationship problems, for example with a partner who is also obese, and it may result in unwanted loose folds of skin, which may require 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.
For more information, see Weight loss surgery - recommendations and risks.
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:
It is estimated that the risk of dying shortly after bariatric surgery is around 1 in 200.
However, this risk can be as high as 1 in 40 if you have other risk factors such as high blood pressure or a BMI of 50 or above.
For more information, see Weight loss surgery - risks.
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.
