Guidelines for surgery

The following are very general guidelines for surgery based on Body Mass Index (BMI kg/m²).  (Check your BMI) 

BMI 27 and over

• Gastric balloon
  Useful and very safe option for non-obese patients but it is a temporary tool. Balloon must be removed at 6 or 12 months so you must make a genuine long-term commitment to change lifestyle and eating habits or you will regain your lost weight.

BMI 30 and over

• Gastric band (LAGB)
  The LAGB is the safest surgical procedure and is the first choice for patients with lower grades of obesity.  Overall around 85% will do well with the gastric band and some studies show that at 5 years weight loss is as good as gastric bypass. 

BMI 35 and over

• Gastric band (LAGB)
  If you are committed to working with the gastric band then this would still be the first choice.  It will deliver average weight loss of 60% excess weight with good long-term results. 

• Gastric bypass (RYGBP)

  If you have associated conditions such as type II diabetes, hypertension etc, or if you have strong family history of these conditions, then a gastric bypass is a good alternative.     

• Sleeve Gastrectomy
  If you have associated conditions such as type II diabetes, hypertension etc, or if you have strong family history of these conditions, then a sleeve gastrectomy is a good alternative.     

BMI 45 and over

• Gastric bypass (RYGBP)
  You should consider a RYGBP, especially if you have weight-related health problems eg diabetes, arthritis. The RYGBP will deliver weight loss of around 70% excess weight with improvement or complete resolution of many weight-related diseases. 

• Gastric band (LAGB) 
  If your general health is good and you are committed to working with a gastric band then this is still an excellent option which will also deliver excellent long-term results. 

• Sleeve Gastrectomy
  The other increasingly popular option is a sleeve gastrectomy, though the long-term results from this procedure are still to be determined.    

BMI 50 and over

• Gastric bypass (RYGBP)
  The first choice would be gastric bypass (RYGBP) or a sleeve gastrectomy. Both procedures will deliver excellent weight loss with improvement or complete resolution of weight-related conditions such as diabetes and hypertension. 

• Sleeve Gastrectomy
  If you are in a high-risk group because of  previous health problems then a sleeve gastrectomy is a good alternative which is easily converted into a BPD/DS at a later stage if necessary. 

• Gastric band (LAGB) 
  Another very good strategy for those whose health is poor, is to start with the gastric band (the safest of all the procedures) which could be converted to a BPD/DS (Bandinaro) at a later stage if necessary

• Biliopancreatic diversion / Duodenal Switch (BPD/DS)
  Very occasionally the BPD/DS may be the first choice, especially if your BMI has previously been more than 60kg/m².    

BMI 60 and over

• Biliopancreatic diversion / Duodenal Switch (BPD/DS) ± sleeve gastrectomy
  The BPD/DS should be considered as a first option.  It is the most powerful surgical treatment available and delivers average weight loss equivalent to 80% of excess weight with major – and sometimes dramatic – improvements in weight-associated conditions. For example, almost all type II diabetics are completely cured. 

• Long limb Roux-en-Y gastric bypass (RYGBP)
  

  If there is a previous history of poor health, it may be wise to start with sleeve gastrectomy and proceed to the full BPD/DS around 12 months later if needed. The other option would be a “long-limb” RYGBP

For more information about your options based on your individual needs,

call our patient care team on 0800 313 4618