Your Comprehensive Guide to Weight Loss Surgery

Types, Benefits, and What to Expect

Are you considering weight loss surgery? This guide will help you understand what it involves, the main types of procedures, the benefits, the risks, and what to expect during your journey to lose weight.

Bariatric surgery is an effective treatment option for individuals with obesity, aimed at achieving significant and sustainable weight loss when traditional methods fail.

Common weight loss surgeries include gastric sleeve (sleeve gastrectomy), gastric bypass, and adjustable gastric banding, each with distinct methods, benefits, and risks tailored to individual needs.

Candidates for bariatric surgery typically have a BMI (Body Mass Index) of 35 or higher, with or without existing weight-related conditions such as high blood pressure, type 2 diabetes, heart disease etc.

Understanding Weight Loss Surgery

Weight loss surgery, or bariatric surgery, is a surgical procedure designed to help individuals with obesity or morbid obesity lose weight by altering the digestive system.  Obesity surgery is typically considered when traditional methods like diet and exercise have failed to lose weight, significant obesity-related health issues are present, or indeed, both. The primary goal of these surgeries is to achieve significant weight loss and maintain it over the long term.

Simply put, weight loss surgery reduces the size of the stomach, helping patients feel full faster and, consequently, eat less. Additionally, these bariatric operations can alter gut hormones, leading to reduced hunger and improved metabolism. Metabolic and bariatric surgery can also provide significant physical and mental health benefits for patients and improve their eating habits for life.

Candidates should have attempted weight loss through diet and exercise before considering bariatric surgical procedures. It follows that surgery is often a last resort for managing severe obesity and its related conditions in most patients.

Common Types of Bariatric Surgery Procedures

Bariatric surgery includes various procedures, each tailored to a patient’s individualised needs, medical history, and bariatric surgery requirements. Some of the most commonly performed bariatric surgeries include gastric sleeve surgery, gastric bypass surgery, and adjustable gastric band surgery. These operations are customised to the patient’s specific health needs for optimal results.

Gastric sleeve (sleeve gastrectomy) and gastric bypass surgeries are famous for their effectiveness in offering more weight loss and managing obesity-related health issues. However, there are other procedures available, such as gastric band and  SADI-S or duodenal switch, each with its unique benefits and risks involved.

Understanding these options is crucial for making an informed decision about which procedure might best suit your needs. Your bariatric surgeon and their team will support you in this decision making process and it is essential to consult with a qualified healthcare professional to determine if this procedure is suitable for your individual circumstances.

Gastric Sleeve Surgery (Sleeve Gastrectomy)

Gastric sleeve surgery, also known as sleeve gastrectomy surgery, involves removing a large portion of the stomach, leaving behind a sleeve-shaped or banana-shaped narrow stomach. This significantly smaller stomach limits the amount of food that can be consumed at one time, promoting weight loss by reducing food intake.

Sleeve gastrectomy also influences hormones regulating/reducing hunger and regulating metabolism. This dual approach helps patients lose more weight and enhances their ability to maintain that weight loss over time.

The procedure is typically performed using laparoscopic surgery/keyhole surgery, which involves small incisions in the abdomen, providing a quicker recovery time when compared to open surgery.

Gastric Bypass Surgery (Roux-en-Y)

Gastric bypass surgery, also known as the Roux-en-Y gastric bypass, is another highly effective weight loss surgery. This procedure involves creating a small stomach pouch and rerouting a portion of the small intestine to this new pouch. By bypassing a significant part of the stomach and upper small intestine, gastric bypass surgery reduces calorie absorption from food and influences hormones controlling hunger, promoting rapid weight loss.

Patients who undergo gastric bypass surgery can expect to lose a significant amount of excess weight, often more than 70%, within two years. Creating a smaller stomach pouch means that patients feel full sooner, thereby limiting food intake and aiding in weight loss.

While this surgery is difficult to reverse, it can still be done if medically necessary. Gastric bypass surgery is a powerful tool for those struggling with severe obesity and obesity-related health issues (morbid obesity).

Roux-en-Y Gastric Bypass is now most frequently used for those patients with significant acid reflux or heartburn (see “Mini” Gastric Bypass below).

“Mini” Gastric Bypass (One Anastomosis or OAGB)

The mini gastric bypass is a less complex alternative to the traditional gastric bypass surgery. This procedure involves creating a small stomach pouch and rerouting a portion of the small intestine to this new pouch, similar to the traditional bypass but with fewer steps and fewer joins involving the bowel or small intestine. This less complex and shorter surgical procedure should result in quicker recovery times and reduced post-surgical complications.

Patients who undergo mini gastric bypass benefit from restricted food intake and early satiety, which helps in reducing overall calorie consumption. This procedure can lead to the most significant weight loss and improvements in overall health compared with other routinely available obesity surgery treatments.

Adjustable Gastric Banding

The adjustable gastric band, commonly known as the “Gastric Band”, involves placing a band around the upper part of the stomach to create a small pouch of stomach above the band. This band can be adjusted through saline injections, allowing for control over the amount of food  this stomach pouch can hold. The adjustable nature of the band provides flexibility in managing weight loss over time.

This procedure helps patients feel full sooner and eat less, promoting gradual weight loss. The band can be tightened or loosened based on the patient’s progress and needs, making it a customisable option for those seeking a less invasive weight loss surgery.

How Weight Loss Surgery is Performed

Weight loss operations are typically performed in a hospital setting under general anaesthesia. Most modern bariatric procedures use “keyhole” or laparoscopic surgery techniques, which involve small incisions and the use of a camera to guide the surgeon. This minimally invasive approach to bariatric surgery reduces the risks associated with open surgery, such as pain, wound infection, scarring, hernia, and longer recovery times.

The duration of bariatric surgeries can vary, but typically range from 30 minutes (for gastric band and gastric sleeve, 45 minutes for “mini” gastric bypass, to 60 minutes for RY gastric bypass). Shorter surgery and anaesthesia times also reduce the general risks of surgery such as chest infection and blood clots (DVT and/or PE). Shorter recovery times with laparoscopic methods allows patients to return to their normal activities more quickly.

Familiarity with the surgical and anaesthetic process can help patients feel more prepared and confident about undergoing weight loss surgery.

Preparing for Bariatric Surgery

Preparing for bariatric surgery requires multiple steps to ensure optimal outcomes. Initial consultations involve thorough assessments to determine the patient’s fitness for surgery and to discuss available bariatric procedures. Bariatric surgeons will consider factors such as BMI, eating habits and behaviours, and existing health conditions before recommending the most suitable surgical method.

A pre-surgery diet, commonly known as the liver reduction diet (LRD), is often necessary to reduce liver size, enhancing the safety and effectiveness of the surgery. Although it is not the primary aim, most patients will lose weight on the LRD.

Patients are encouraged to increase physical activity and quit smoking weeks before surgery to minimise risks. Psychological evaluations are conducted to assess the patient’s readiness for the lifestyle changes required post-surgery. Family and friends’ support, along with joining support groups, can be invaluable during preparation and recovery.

Patients will meet with various healthcare professionals, including dieticians and specialist nurses, to ensure a comprehensive approach and preparation for their journey to lose weight. This team helps patients understand necessary lifestyle changes and prepares them for successful surgery and long-term weight loss maintenance.

Bariatric surgery patients will also need to attend for pre-surgery blood tests or other tests to ensure safe anaesthesia and surgery.

Post-Surgery Expectations and Recovery

Immediate Post-Surgery Care

Post-surgery, patients usually stay in the hospital for one to two days, depending on the procedure.

It is essential for patients to mobilise following surgery to minimise the risk of potential complications and to assist with pain management and general wellbeing. Patients should gradually increase their physical activity, as advised by their healthcare team.

Post-surgery follow up care ensures a smoother recovery and better long-term outcomes and follow-up appointments are essential for monitoring health and progress.

Dietary Changes After Surgery

Post-surgery recovery includes several stages, initially focusing on allowing the digestive system to heal. Patients typically start with a liquid diet for two weeks, followed by a pureed diet for two weeks, a soft diet for 2 weeks and then gradually progressing to a normal, textured diet after this.

The gradual transition helps the body adjust to the changes in the digestive system. It also allows the patient time to slow down their eating and master a mindful eating approach.

Besides changing food types, patients must focus on eating smaller meals and chewing thoroughly to aid digestion. Healthcare professionals will prescribe vitamins and minerals to prevent deficiencies and support overall health. Adhering to these dietary guidelines is essential for successful weight loss and long-term health maintenance.

Long-term Lifestyle Adjustments

Long-term lifestyle adjustments are essential for maintaining the benefits of weight loss surgery. Patients must commit to permanent changes in eating habits and physical activity levels. This includes following a balanced, varied diet, and increasing activity levels, reducing sedentary periods, ultimately engaging in an exercise program.

Regular follow-up care with healthcare professionals supports long-term weight loss success. These appointments monitor progress, address challenges, and provide ongoing support and guidance.

Embracing a healthier lifestyle and committing to necessary changes can lead to sustained weight loss and improved well-being.

Benefits of Weight Loss Surgery

Weight loss surgery offers many benefits for individuals living with obesity and obesity related conditions (morbid obesity). Weight loss can improve various obesity-related health conditions like diabetes, high blood pressure, heart disease, sleep apnoea, joint pain and depression.

Beyond physical health benefits, weight loss surgery can enhance a patient’s overall quality of life. Many patients report increased well-being, improved daily functioning, and better physical activity engagement.

The surgery also promotes significant metabolic changes, like reduced hunger hormone levels, contributing to sustained weight loss. Hence the term “metabolic and bariatric surgery”.

Risks and Complications of Bariatric Surgery

While bariatric surgery can offer life-changing benefits, understanding the associated bariatric surgery risks and complications is important. Immediate complications, like any surgical procedure, may include bleeding, leaks, blood clots (DVT and PE), and wound and chest infection.

Short-term issues include reflux and swallowing problems.

Long-term risks can involve malnutrition, dumping syndrome, and bowel obstruction from hernia of the small intestine, depending on the specific surgery. Failure to adhere to recommended lifestyle changes post-surgery can also result in weight regain or inadequate weight loss.

Knowing these risks is crucial for making an informed decision about undergoing bariatric surgery and choosing the best bariatric procedure for you.

Who is a Candidate for Bariatric Surgery?

Individuals with a BMI (body mass index) of 35 or above may be considered for bariatric / weight loss surgery, irrespective of having an existing weight-related condition. Those individuals with a BMI of 30 or above who have an existing weight-related condition, such as diabetes, or have not been able to maintain long-term weight loss can be considered for bariatric surgery.  Guidelines advise that the BMI threshold should be lowered in the Asian population due to the prevalence of negative health outcomes associated with a lower BMI.  (IFSO & ASMBS)

Eligibility for weight loss surgery involves extensive screening to ensure the patient’s fitness for the procedure. This includes evaluating the patient’s medical history, dieting history, current weight, and any comorbid conditions. Meeting specific medical criteria is essential for the surgery’s safety and effectiveness.

Summary

Weight loss surgery offers a promising solution for individuals living with obesity and related health issues. By understanding the different types of bariatric surgery, how these procedures are performed, and the necessary preparation and recovery processes, patients can make informed decisions about their weight loss journey. The benefits of these surgeries include significant weight loss, improved health conditions, and enhanced quality of life.

However, it is crucial to recognise the risks and complications associated with bariatric surgery and to commit to the long-term lifestyle and behaviour changes required for success. With the expertise of specialists like Mr. Alan Li, patients can receive the support and guidance they need to achieve their weight loss goals and maintain their health. Weight loss surgery is not just about losing weight; it is about transforming lives and embracing a healthier future.

Mr Alan Li – Surgical Weight Loss Surgery Specialist

Mr Alan Li is a highly experienced weight loss surgery specialist based in Manchester, Cheshire, the North West, and Belfast. With over 6,000 bariatric surgeries and over 10,000 total surgical procedures, Mr. Li is Manchester’s most experienced weight loss and upper GI surgeon. His practice includes routine surgery and complex revision operations, making him a trusted expert.

Mr. Li offers a wide range of weight loss treatments, including surgical options, medical care programs, and support for diet and lifestyle changes. He specialises in advanced surgical techniques, such as laparoscopic and robotic methods, ensuring the best possible outcomes.

With his extensive expertise and patient-centred approach, Mr Li is dedicated to helping individuals achieve weight loss goals and improve overall health.

Cost and Payment Options for Weight Loss Surgery

Many patients consider the cost of weight loss surgery a significant consideration. We offer all-inclusive pricing for weight loss surgery, ensuring patients know their total costs upfront. This comprehensive pricing includes all associated treatment costs, even if the hospital stay is extended. We also guarantee to offer a most competitive price for weight loss surgery in the UK.

Patients have several payment options, including interest-free payment plans and loans. Interest-free payment options allow patients to defer part of the cost and repay it in instalments over 11 months. These flexible payment options make weight loss surgery more accessible. Complete payment for the surgery is required seven working days before the procedure.

Frequently Asked Questions