The number of people affected by serious increase in weight is rising yearly, bringing the danger of poor health and serious medical conditions. Past figures from Health and Social Care Information Centre show that 65 per cent of men and 58 per cent of women in England were either overweight or obese.
Mr Krishna Moorthy, specialist in obesity surgery, explains how gastric band surgery works, and how to decide whether this is the right choice for you.
Health risks that can lead to surgery
Obesity brings some serious health risks with it. According to Public Health England it raises the risk of Type 2 diabetes, high blood pressure, heart disease, stroke, some types of cancer, sleep apnoea, asthma and other conditions.
If you are very overweight, or obese, with a body mass index (BMI) between 30 and 40 (a BMI over 40 is regarded as ‘morbidly obese’, says the NHS), it’s important to try to lose weight for the sake of your health. Your doctor should be able to suggest an appropriate diet, including plenty of healthy, low fat and low calorie foods.
They should also advise you on safe ways to exercise, with advice on how to build up slowly. They may give you an exercise prescription, which would allow you reduced or free access to a local exercise programme.
Ask your GP whether Orlistat – a medication that can help prevent you gaining weight – would be suitable for you.
How a gastric band works
As explained by Mr Krishna Moorthy, a gastric band is made of soft silicone. Using keyhole surgery the band is placed around the top of the stomach. This creates a small pouch (20-25 mls capacity) above the band. The rest of the stomach is below the band.
Your surgeon inserts a port just under your skin in the region of your abdomen. A length of soft tube connects the port to the band. This allows your doctor to insert fluid through the port, to tighten the band. This limits the amount of food that passes from the pouch into your stomach. The result is that you feel full more quickly, and can only eat a limited amount of food.
Pros and cons
Mr Krishna Moorthy’s website explains that gastric band surgery has a number of advantages. It is a safe and quick operation, and patients can usually go home on the same day. It has the least risk of complications when compared to other types of surgery, such as a gastric bypass or a sleeve gastrectomy.
Having a gastric band means that the surgeon can adjust the fit to make it tighter or looser. A gastric band can even be removed altogether, or converted to a sleeve gastrectomy or a gastric bypass (alternative forms of bariatric surgery).
“With a gastric band we would say that you can expect to lose 15 to 20 per cent of your body weight,” says Mr Moorthy. “It’s quite a slow process – it takes about two to three years to achieve this.”
For this reason a gastric band is not the best option if you have a BMI of 60. After two years and a loss of 20 per cent of your body weight, this would leave you with a BMI of about 45. “In these cases another operation, a sleeve gastrectomy or a gastric bypass, would be better,” says Mr Moorthy.
Is it right for you?
Before you make the decision to have gastric band surgery, it’s important to know what is involved. “Under National Institute for Health and Care Excellence (NICE) guidelines you must have a BMI of 40 or more to fit the necessary criteria for this surgery. Or you should have a BMI of 35 or more, with one of the accepted obesity-related diseases, such as diabetes, high blood pressure, sleep apnoea or polycystic ovaries.”
Diabetes, high blood pressure and sleep apnoea are very common among obese patients, and this surgery can have a big impact on these conditions.
“You have to have the right patient for a gastric band – they have to be highly motivated to change their eating habits and to exercise every day,” says Mr Moorthy.
Before the operation you would need to go on a low calorie diet for two weeks, take short walks every day and do breathing exercises. “After bariatric surgery patients have to keep to some golden rules of eating,” says Mr Moorthy.
“They must eat slowly, chew their food very well and not consume fluids along with their meals, for instance.”
There can also be problems after the procedure, says patient.co.uk. These can include the band slipping or leaking, and feeling sick or vomiting, due to overeating.
"I say to my patients 'I’m not in the slimming business – I aim to make you healthier'," says Mr Moorthy.
"We’re operating on you because by losing weight your risk of having a heart attack, stroke, high blood pressure or worsening diabetes will come down, and you’ll live a longer life."
Health and Social Care
Public Health England
Mr Krishna Moorthy