Weight Loss Surgery

Weight loss surgery is an effective way of tackling your weight problem whilst controlling, and even reversing, weight related health problems.

Here, we give a comprehensive breakdown of each procedure and explore your eligibility.

Weight Loss Surgery

By Mr Rishi Singhal MBBS, MRCS, FRCS, MD

Last review: 10/09/2020. All content on this page is reviewed by a multi-disciplinary team lead by Mr Rishi Singhal.

Introduction

At Healthier Weight, we offer the full of range of weight loss surgery procedures. We have an experienced, dedicated and supportive team of Patient Care Coordinators ready to guide you through your options and any questions you may have. What’s more, you can take advantage of a free weight loss surgery consultation where you get 1-2-1 access to world renowned bariatric (weight loss) surgeons either face to face, or from the comfort of your own home via video link.

Our team of patient support, nurses and surgeons will give you reliable and honest advice, support and education regarding weight loss surgery, and guide you through every step of the process.

On this page, we give you a breakdown of all of the procedures, as well as explore your eligibility for each.

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. Our team has done over 20,000 band procedures and it’s an option everyone contemplating bariatric surgery should consider.

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The adjustable gastric band (also known as the Lap-band) has two main parts. The first is the band itself which is a small, hollow silicone band that is placed around the stomach. The other part is the access port which is small and disc shaped. It is usually about 0.5cm deep. The band and the port are connected by a tube.

So, when you have a band adjustment, we access the port by injecting into it with a syringe. We inject a small amount of saline (salt water). As we inject more fluid into the band it tracks up the tubing and causes the band to tighten around the stomach. Equally, by removing fluid from the band we can cause it to loosen around the stomach. The band is loosened or tightened to maximise weight loss.

The gastric band is implanted laparoscopically (‘keyhole’ surgery) and usually takes around 30-45 minutes. The procedure is done under general anaesthetic. This is for two reasons; your comfort during surgery and also to achieve the muscle relaxation in the abdomen that is necessary.

There are many factors to consider for eligibility but we generally offer the gastric band procedure to those with a minimum body mass index (BMI) of 30.

Not only is the gastric band a very safe procedure but it is also very effective. How successful you are with the band depends on how well you are able to adapt to the diet and eating regime required for success. Our team is here to help you with that every step of the way.

Your weight loss will vary according to how well you are able to follow the rules for band success. They are to eat slowly, to eat foods of the right texture and to cut out high-calorie soft foods and drinks. As a guide, you can expect to lose 50-60% of your excess weight over the first 2 years although many patients will do much better than this (see before and after photos and stories from successful gastric band patients here).

For a woman who is 5 foot 5 inches tall and who weighs 18 stone at the time of her band procedure this means that she could expect to lose, on average, about 4 stone. This would vary up or down according to how well you are able to develop the eating habits required for long term success with the band.

Taking an example of a man who is 5 foot 10 inches tall and weighs 21 stone at the time of surgery, we could expect weight loss, on average, of about 5 stone.

Long term results

Healthier Weight is proud to have published our gastric band outcomes in numerous publications over our 16 year history, including the largest ever study into gastric band outcomes for UK private patients. It’s important to ask whether your provider publishes their results and we recommend you ask to see their data to ensure that the expected outcomes they quote are accurate and not based on average results achieved elsewhere.

What about 10+ years from now? Since the first laparoscopic gastric band procedure in 1993, evidence shows lasting weight loss for most people and the device itself does not degrade in any significant way. This is especially true of the latest generation of devices. Although we don’t yet have studies showing what happens to gastric bands after 30 or 40 years, we have no reason to doubt that the lap band will function perfectly well for decades.

Weight loss outcomes are impossible to predict at outset and, more than any other procedure, your weight loss success with the band will depend on how well you adapt to the dietary regime required for success. If you are able to do you may be one of those people who is able to lose all of their excess weight and take yourself out of the ‘obese’ category. At the other extreme, as with all procedures, there will be a failure rate and about 1 in 10 patients will be unable to lose weight with the band.

Gastric banding has a major, often dramatic, impact on a wide variety of obesity associated health conditions. In addition to the health benefits, gastric banding is shown to improve quality of life and increase life expectancy.

  • Approximately 60% of type II diabetics are cured
  • 70-80% of patients with high blood pressure reduce or stop medication
  • 80% will have improvement in cholesterol levels
  • 90% will have improvement in reflux symptoms
  • Most people with sleep apnoea are cured
  • Mobility improves dramatically and joint pain decreases
  • Improvements in mood and self-esteem

Stress Incontinence
Most patients experience marked improvement or complete resolution of symptoms

Infertility and PCOS*
90% of patients experience correction of underlying hormonal problems and restored fertility

Asthma
Patients with asthma see marked improvement in symptoms and a reduction in medication

Liver Disease (NASH)
80% of patients will have complete resolution of liver disease

Back Pain and Arthritis
Patients experience marked reduction in joint and back pain and increased mobility

Psychological Wellbeing
Reduced depressive symptoms and anxiety, improved social interaction and overall quality of life

 

It is no exaggeration to say that aftercare is the key ingredient in your gastric band success. You’ll need the right band adjustments, coaching and support to develop the habits needed for success. Our team is dedicated to providing you with that support.

Put simply, to get good and safe long term weight loss from your band it needs correct adjustment. That means adjustments at the right time, of the right amount and by a properly trained bariatric (weight loss) nurse.

As a Healthier Weight band patient, you’ll receive free of charge band adjustments for 2 years. Those adjustments will be carried out by our specialist team of bariatric nurses. You are likely to need 3 band adjustments in the first 6 months to get your band working just right for you.

Our aftercare Package has been developed to provide everything you need for success.

Gastric band success stories

Chris – Gastric band

I’d tried every other diet under the sun – and I gave up on all of them. But with my gastric band, I didn’t give up, and now my life is completely different

Read More »

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 and now accounts for more procedures in the NHS than the gastric band or gastric bypass. 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.

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The gastric sleeve is a simple concept. We access the abdomen laparoscopically (keyhole surgery) and cut the stomach along its length and remove about 80%. After sleeve surgery, the food you eat will still enter and exit the stomach in the same place as it did before (unlike the gastric bypass) but you’ll have a much smaller stomach.

The gastric sleeve works in two ways:

  1. 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.

  2. 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.

There are many factors to consider for eligibility but we generally offer the gastric sleeve procedure to those with a minimum body mass index (BMI) of 35.

The primary reason most patients choose gastric sleeve is to lose weight. It’s a very powerful procedure and most studies show average (mean) excess weight loss of 60-70%* over a 2 year period. Some studies show even better weight loss results but we think this is a reasonable expectation. One of the attractions is that the weight is usually lost as quickly, as the procedure reduces and changes appetite. You’ll see in our patient success stories section that people achieve spectacular results with the sleeve.

Of course, to maintain the weight loss for the long term it’s important to make changes to your diet and exercise habits so that you can maintain your weight loss in later years should the ‘power’ of your sleeve begin to diminish.

*Surg Obes Relat Dis. 2011 Nov-Dec;7(6):749-59. doi: 10.1016/j.soard.2011.07.017. Epub 2011 Aug 10. Third International Summit: Current status of sleeve gastrectomy

The gastric sleeve is the fastest growing weight loss surgery procedure in the world because it delivers excellent weight loss results and improvements to health. The knock on effect of both is that it also helps patients achieve an improved quality of life.

Here are the benefits you can expect from your sleeve surgery. These are taken from respected scientific journals and the relevant publications are shown at the foot of this page.

Type 2 Diabetes

The sleeve is an excellent procedure for diabetics and 80% of patients can expect a complete resolution of their symptoms

Raised Blood Pressure (Hypertension)

85-90% of patients who are taking medication to reduce their blood pressure can expect top stop medication altogether.

Sleep Apnoea

Patients see improved sleep patterns and reduced fatigue. Over 85% of patients who use a CPAP machine will be able to stop.

Infertility and PCOS

A very important consideration for some sleeve patients is that they want to lose weight to start or grow their family. Over 90% of sleeve patients improve their underlying hormonal well-being and restore fertility.

Back Pain and Arthritis

An important consideration for many patients is that their weight is being to impact on their mobility and is causing joint pain. The sleeve can help this by reducing the load that joints are bearing. Studies show that patients report increased mobility after sleeve surgery.

Mental Wellbeing

This is a very important benefit of the gastric sleeve. Often, patients have been dealing with mental health issues associated with their weight for many years. Studies show that sleeve patients report a reduction in anxiety and depressive symptoms. They also report a significant improvement in overall quality of life.

We pay great attention to mental health in our pre-operative assessment process. There is evidence to show that suicide among weight loss surgery patients is higher than in the general population. This is a complex area and there will be many possible reasons for this. One is that some patients have developed a ‘dependency’ on food and when that is removed it will transfer elsewhere sometimes to alcohol or drugs. Our pre-operative screening process is designed to ensure long-term mental well-being for our weight loss surgery patients. Our programme was developed by Dr Claire Parkes, Psychologist.

Dyslipidaemia

There are other health benefits, for example in respect of Asthma and liver disease but we have not listed all of them here. If there is a health problem we have not listed that you wish to enquire about, please call us and we’ll be happy to discuss it with you.

The importance of great aftercare is often underestimated when it comes to gastric sleeve. Most patients enjoy excellent weight loss in the first year or two but some weight regain is quite common after a few years. This can be reduced by adopting the correct dietary and exercise habits in the first couple of years after surgery.

Gastric sleeve success stories

Gastric Bypass

The gastric bypass is a long established weight loss procedure. Over 30 years it has proven to be safe and effective, delivering both excellent weight loss outcomes and significant health benefits. In fact, for people experiencing health problems associated with their weight, the bypass is generally the best procedure available.

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The simplest way to describe it is to say that the stomach and bowel are ‘re-plumbed’ so that the food you eat goes into a reduced stomach before passing directly into the bowel a little further down the bowel than was the case before.

The bypass works in two ways. Firstly, by reducing the size of the stomach and so restricting the amount of food that can be eaten. We usually reduce the stomach’s capacity by as much as 90-95%.

There are many factors to consider for eligibility but we generally offer the gastric bypass procedure to those with a minimum body mass index (BMI) of 35.

Of course, the main benefit people are seeking when they have bypass surgery is to lose weight. There are other significant benefits however, especially where improvements in health are concerned. Those people who are managing health problems associated with their weight can expect significant improvements after bypass.

Typically, we expect gastric bypass patients to lose 60-70% of their excess weight over a 2-year period, and most of this weight is lost in the first year after surgery*. You will see from our case studies that some people lose all their excess weight. To compensate there will be some who lose a little less. For this reason, 60-70% is a reasonable expectation. Weight loss results will differ from person to person and your results, especially in the long term, will depend on how well you are able to adapt your lifestyle and eating habits. For this reason, although the gastric bypass procedure itself is extremely powerful, the support and guidance from our bariatric aftercare team is vital to helping you learn and embed the skills needed to maximise and to maintain your weight loss (see before and after photos and stories from gastric bypass patients here).

Weight loss example

  • A 5ft 6in person weighing 17st (240lbs / 109kgs) has an ideal weight of about 11st (154lbs / 70kgs)
  • They are carrying excess weight therefore of 86lbs (240lbs actual weight minus 154lbs ideal weight)
  • 70% of 86lbs is around 60lbs
  • So, this person could expect to lose (on average) about 60lbs (27kgs).

Scientific evidence suggests that most gastric bypass patients who comply with the follow-up requirements, including nutritional recommendations, do very well, and see great long-term results*. Moreover, compared with obese individuals who have not had surgery, gastric bypass patients have a much lower risk of premature death and disability.

*JAMA. 2012 Jan 4;307(1):56-65. doi: 10.1001/jama.2011.1914. Bariatric surgery and long-term cardiovascular events

Turning to the health benefits bypass patients can expect, it’s a long list and the improvements are usually very significant. In many cases people see a complete resolution of their symptoms for the problem they are managing.  Here are some of the more common weight related health problems and the benefit people can expect.**

As specialists in weight loss surgery we are familiar with all the health issues associated with obesity. It is also our duty to inform all our patients of the risks and potential complications of gastric bypass surgery, you can view these here. If you have specific health question, please do contact our team and we’ll be pleased to discuss them with you.

Video: How my health improved after weight loss surgery

**Buchwald H et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004 Oct 13;292(14):1724-37.

The importance of aftercare and support is often underestimated with the gastric bypass. Often people think the procedure is so powerful that they lose weight without too much effort, especially in the early months. However, over time the power of bypass will subside, and it will be the diet, eating and exercise changes that you have made in the years after your surgery that will help you maintain your weight loss.

Our team is here to see you in clinic and to provide the support you need for enduring success.

With this in mind, we have developed an aftercare and support package that we consider to be the most comprehensive of its type in the UK.

Our aftercare package has been developed to provide everything you need for success.

Gastric bypass success stories

Michelle reversed type 2 diabetes after weight loss surgery
Michelle – Gastric bypass

10 months post surgery my HBA1C, which was 58 (over 42 is considered diabetic) is now 31 and has been for 7 months, which means my diabetes is in remission and if it stays that way for 12 months, it will be in full remission.

Read More »

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.

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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.

There are many factors to consider for eligibility but we generally offer the ESG procedure to those with a minimum body mass index (BMI) of 30.

The weight loss results with ESG are excellent. Initially we were seeing weight loss similar to that for gastric band at 50-60% excess weight loss after 2 years, however the latest results are more encouraging. The Longitudinal Compression technique used is now delivering over 50% excess loss in the first 6 months which is comparable to surgical sleeve and gastric bypass.

We always stress to patients that we need to wait to see long term results, 5 years plus, to be satisfied with the long-term benefits of the procedure but the fact we are seeing over 50% at 6 months and generally 60% at 2 years is very positive. It is too early to tell but we expect that the technique used will encourage enduring weight loss as well as good results for the short term.

Through losing weight ESG patients will enjoy the same benefits that accrue from weight loss with any procedure, including improvements in:

Whichever weight loss procedure you have, long term success requires that you learn to work with your procedure and adapt your diet and eating. In this way you can achieve and then sustain your weight loss for the long term.

Anyone who has had a weight loss procedure will tell you that the importance of aftercare and support can never be overestimated.

Our package has been developed based on our experience of supporting weight loss patients for over 15 years. It’s comprehensive and ensures that you receive the specialist input needed to develop the skills that will enable you to get the best possible results.

Procedure Comparison

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.

Eligibility Explained

Body mass index (BMI) is the measure most often used by medical professionals to determine if you have a healthy body weight. The higher your BMI, the more your health is at risk.

Weight loss surgery, and the procedure you will be eligible for is determined largely on your BMI, although other factors will determine it your BMI is the decisive factor.

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. To find out your current level, and your eligibility options, use our BMI calculator.

Monthly Payment Plans

We appreciate that getting value and affordability out of your provider is a huge factor when choosing your weight loss procedure, and your decision should not be restricted by cost.

You can now spread the cost of your procedure over 5 years with our monthly payment plans. Use our repayment calculator to configure your own monthly payment plan.

Mr Rishi Singhal MBBS, MRCS, FRCS, MD

Mr Rishi Singhal MBBS, MRCS, FRCS, MD

Mr Singhal is an expert bariatric surgeon based in the West Midlands and also Medical Director at Healthier Weight

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