NHS Guidance – Are You Thinking About Bariatric Surgery To Help With Weight Loss?
Weight loss surgery, also called bariatric or metabolic surgery, is sometimes used as a treatment for people who are very obese. If you have tried all other weight loss methods, such as modifying and restricting your dietary intake and exercise, but have struggled to lose weight or keep it off then surgery may be an option for you.
After Bariatric surgery you will need to commit to making lifelong healthy lifestyle changes in order for the surgery to be successful and prevent weight regain in the future.
Weight loss surgery is available to be funded on the NHS if you meet certain criteria:
- you have a body mass index (BMI) of 40 or more, or a BMI between 35 and 40 and an obesity-related condition that might improve if you lost weight (such as type 2 diabetes or high blood pressure)
- you have tried all other weight loss methods, such as dieting and exercise, but have struggled to lose weight or keep it off
- you agree to long-term follow-up after surgery– such as making healthy lifestyle changes and attending regular check-ups
Speak to your GP if you think weight loss surgery may be an option for you. If you qualify for NHS treatment, they can refer you for an assessment to check surgery is suitable. The nearest bariatric surgical team are at Calderdale and Huddersfield NHS Foundation Trust.
For more information about bariatric surgery please refer to the following website: https://www.nhs.uk/conditions/weight-loss-surgery/
The following webinars may be useful to watch, to provide you with more information about the types of surgery, risks and benefits of surgery and psychological factors which affect our food choices. There is also information on the dietary modifications required immediately post operatively and then how to achieve weight loss after surgery in order to be successful in the long term.
Frequently Asked Questions About Bariatric Surgery
What is Bariatric Surgery and how does it help weight loss?
Weight loss surgery, can also be called bariatric or metabolic surgery. It is sometimes used as a treatment for people who are very obese.
Would I be a candidate for Bariatric Surgery?
There is strict criteria to be considered for bariatric surgery. This includes:
- A BMI of 40 kg/m2 or more, or between 35 kg/m2 and 40 kg/m2 and other significant disease (for example, type 2 diabetes or high blood pressure) that could be improved if they lost weight.
- Non-surgical attempts of weight loss but has not been achieved or maintained
- Fit for anaesthesia and surgery
- Commitment for long term follow-up
If you think you would be eligible for bariatric surgery, please discuss this with your GP.
Do I need to Change my diet after Bariatric Surgery?
Yes – whilst your stomach is healing you will be given a diet plan to follow after surgery.
These vary with each surgery, but a typical plan is:
- first day – water and fluids only
- first 6 weeks – 1-3 tablespoons puree food without lumps (for example yoghurt or weetabix)
- weeks 6 to 10 – 3 tablespoons soft/mashable food (for example, mashed potato, scrambled egg)
- week 10 onwards – 3-4 tablespoons, gradually return to a healthy, balanced diet of normal texture
You will also be advised to:
- eat slowly, chew well and only eat small amounts at a time – particularly during the early stages of your recovery
- avoid, or be careful when eating, foods that could block your stomach, such as soft white bread
- take vitamin and mineral supplements daily
- Separate your drinks and food by at least 30 minutes
What are the risks of Bariatric Surgery?
As with any other surgical procedures, there are risks associated, although complication rates for weight loss surgery are low.
Some associated risks are:
- Leaks in the stomach
- Internal bleeding
- Reactions to anaesthesia
- Blood clots within the legs and lungs
- Internal twisting of the bowel can happen at a later stage
How much weight should I expect to lose?
No specific amount of weight loss is guaranteed. If you follow the dietary advice, meal plans provided and exercise regularly you could expect to lose upto 70% of your excess weight.
More than 95% of patients will successfully lose half of their extra body weight or more after surgery for weight loss.
What happens after Bariatric Surgery?
A follow-up care package for a minimum of 2 years is provided. This includes:
- monitoring nutritional intake (including protein, vitamin and mineral deficiencies)
- monitoring for comorbidities
- medication review
- dietary and nutritional assessment, advice and support
- physical activity advice and support
- psychological support tailored to the individual
- information about professionally led or peer-support groups.
All patients who undergo bariatric surgery need to take lifelong vitamin and mineral supplements. These will vary slightly depending on the type of surgery you have. Most patients will require 3 monthly vitamin B12 injections as well as tablets daily. Failure to take the recommended supplements can result in serious health problems such as fits, blindness and even death.
Will I have to exercise after the procedure?
For many patients, exercise is important for stress control and appetite control, as well as burning off calories. For the first 6 weeks take care not to lift anything heavier than 5Kg, and keep active with walking and doing stairs in the early days post operatively.
As we age, lack of activity can lead to being frail or fragile, which is quite dangerous to overall health. Healthy bones and avoiding muscle loss partly depends on doing weekly exercise.
Most patients also think of exercise as something that must be intense and painful (like “boot camp”). Regular, modest activity is far more useful in the long term. Try to find a variety of activities that can work for you. There is no “one-size-fits-all” plan. Expect to learn and change as you go!
Can I get pregnant after Bariatric Surgery?
Pregnancy should not be planned until your weight is stable; this is usually after the first 18-24 months from your surgery. During this period, you will be experiencing rapid weight loss and you are most at risk of vitamin and mineral deficiencies which may be harmful to the baby.
The effectiveness of the pill may be reduced after surgery so you should seek advice on alternative methods of contraception.
Will I lose my hair after surgery?
Some hair loss is common between 3 and 6 months following surgery but almost always temporary.
The reasons for hair loss are not totally understood. Even if you take all recommended supplements and meet protein requirements, hair loss will be noticed until the follicles come back. Adequate intake of protein, vitamins, and minerals will help to ensure hair re-growth, and avoid longer term thinning. Specific supplements or shampoos often do not help and can be expensive.
Can I go to a private hospital or abroad to have surgery?
If you choose to explore bariatric surgery in a private hospital or overseas it is important to make background checks to check the surgery is going to be safe and appropriate for you.
The type of checks you should make include:
Confirm your surgeon’s qualifications and credentials.
Ensure the clinic or hospital is accredited.
Clarify the overall cost of your procedure including follow up arrangements with a dietitian/Bariatric nurse and psychologist.
What assessments, education and support is there before and after the surgery.
Confirm when you will be safe to fly home.
Who to contact or what to do if there are complications?