There are several factors to consider when deciding which weight loss surgery procedure is right for you, the first is your body mass index (BMI). If your BMI is over 30 you are eligible for the gastric band or ESG (non-surgical sleeve), if it’s over 35, you are eligible for either a gastric band, gastric sleeve, gastric bypass or ESG with Healthier Weight.
For most adults, an ideal BMI is in the 18.5 to 24.9 range, while obesity is classed as somebody having a BMI over 30. In England, 28.7% of adults are now classified as obese and a further 35.6% are overweight but not obese, and both numbers are increasing rapidly.
We know that obesity places you at an increased risk from several diseases including heart disease, some cancers and type 2 diabetes to mention just a few. The effect is that life expectancy is shortened, and the higher your BMI the more your life expectancy is reduced. Indeed, when your BMI gets above 40 the risk to your health ramps up very quickly.
When you have your free consultation with one of our specialist surgeons, they will ask whether you have any underlying health conditions and what your primary weight loss goals are. Each procedure is very unique in the way it helps you lose weight, and some are more intrusive than others but can lead to better results in terms of weight loss.
The gastric band
The gastric band is the most well-known form of weight loss surgery in the UK. The band is a good option for people who want a less invasive procedure that is reversible and can be done as a day case. The gastric band works by encouraging a feeling of fullness on a smaller portion when you eat foods of the right texture slowly. Read our article on what you can eat with a gastric band here.
A silicone band is placed around the top of the stomach to create a small stomach ‘pouch’ above the band with the larger stomach below. The food you eat passes into the smaller stomach above the band before quickly squeezing ‘through’ the band into the larger stomach. It is this squeezing that encourages an earlier feeling of fullness, but you must eat slowly to recognise this.
In addition to being the safest form of weight loss surgery, it is also very effective. On average we expect patients to lose about half of their excess weight over a 2 year period (most in year one) and for most of that weight loss to be sustained over the long term.
The gastric sleeve
The gastric sleeve is now the most common form of weight loss surgery across the world. It is a powerful procedure that suppresses the appetite. Patients can expect to lose most of their excess weight and quickly. We expect sleeve patients to achieve around 70% excess weight loss over a 2 year period.
The gastric sleeve works in two ways:
- By restricting the amount you can eat
A large part of the stomach is removed during surgery leaving a smaller, narrower stomach that looks like a ‘sleeve’. In total, about 80% of the original stomach is removed.
- By impacting on gut hormones
Levels of the hormone Ghrelin fall after sleeve surgery, which explains why patients experience a marked change and reduction in appetite. Sleeve patients report major changes in taste and food preferences towards a healthier diet. This also aids weight loss.
The gastric bypass
The gastric bypass is generally regarded as the king of weight loss procedures. It is long-established and has proven to be both safe and effective. Patients can expect to lose about 70% of their excess weight over 2 years and most of this weight loss is maintained in the long term.
The bypass requires division of the stomach and the bowel. Unlike the sleeve, none of the stomach is removed but food is routed differently (more quickly) through a smaller stomach into the bowel. Time in surgery is about 1 hour 15 minutes. Not only does the bypass deliver excellent weight loss results but it is also the most effective procedure for reversing weight-related health problems.
The ESG (non-surgical sleeve)
The Endoscopic Sleeve Gastroplasty (ESG) is an exciting development in obesity treatment that offers people a safe and effective alternative to the established weight loss options. Its main attraction is that it is non-surgical so people benefit from a lower risk profile and faster recovery time.
The technique we use for ESG was developed by specialist bariatric surgeon, Mr Jamie Kelly, at our centre of excellence in Southampton. Mr Kelly is a world leader in ESG and sits on the manufacturer’s European Advisory Board.
Mr Kelly has developed an ESG technique known as Longitudinal Compression and it’s with this technique that ESG patients can benefit from more sutures than with the traditional technique. Therefore, Mr Kelly’s approach is now shown to deliver better weight loss outcomes with very low complication rates.
The ESG involves suturing the stomach from the inside to significantly reduce its capacity by up to 80%. After the procedure, the stomach remains intact but has been sutured from top to bottom to leave a smaller banana shaped stomach through which the food you eat passes.
Which weight loss surgery procedure is right for me?
Selecting the correct procedure and understanding what is required to be successful with that procedure is the first and most important step in your weight loss journey.
At Healthier Weight, our priority is to provide the procedure and ongoing support to help you reach your target weight, and as a result, improving your health and quality of life for the long term. Below is a table that compares all of the weight loss surgery procedures that we offer. This might help you in deciding which weight loss surgery procedure is right for you.
Most of our patients tell us that they had been contemplating surgery for a long time, sometimes years. We fully understand that it is not a decision people take lightly, and we will support you through the decision making process to make the best choice for you.
Can I get weight loss surgery on the NHS?
Criteria in the NHS requires a higher BMI. In addition, most NHS Trusts further restrict procedure numbers by adding additional requirements. You would for example, probably need to have a weight-related disease.
There is also a requirement to follow an NHS weight loss programme (called Tier 3) for a minimum of 6 months. This can be very difficult to adhere to. In some parts of the country, smokers are also ineligible for NHS treatment.
The result is that a very small number of procedures, just a few thousand per year, take place on the NHS. In reality, it is likely that you will need to be morbidly obese (BMI 40+) and suffering from a weight-related disease to meet the NHS criteria. In addition, those few people who are eligible will find that waiting lists are generally very long. Often, people wait more than two years from the date that their GP refers them for treatment.
If you’re thinking of having weight loss surgery but aren’t sure which procedure is right for you, why not call the Healthier Weight team on 0800 313 4618 to get some information on the surgical and non-surgical treatment options available to you, or click the button below to get a quote.
Article by Mr Rishi Singhal MBBS, MRCS, FRCS, MD
Last review: 03/09/2020. All content on this page is reviewed by a multi-disciplinary team lead by Mr Rishi Singhal.