Most people who come to see me for their initial consultation are anxious. They have usually been thinking about surgery as an option for a long time, however have lacked the courage to come forward due to the guilt they feel for having become obese or perhaps have been put off by the fear of surgery and its potential risks.
In this day and age, the internet has become a major source of information for a lot of people, which is helpful if the information is factual and accurate. Unfortunately, it can also be a conduit for rumours, scaremongering, biased opinions and a vent for people who have had a negative experience whatever that may be.
If you are performing internet searches or joining online forums for people who have had weight loss surgery, it is really important to be selective and critical of the information provided. Remind yourself that there is no surgery without risk and in the case of bariatric surgery risks are in the order of 1-2%, which means that 98% of individuals pursuing surgery get what they want and have a great experience.
To put risk into context, one must understand the benefits of bariatric surgery. Surgeons collect anonymised data about their patients, and what they like to see is a decrease in obesity-related health problems and a better quality of life following surgery.
We now have enough data to show exactly that. One to two years following surgery, people who suffer from type 2 diabetes have usually been able to reduce the dosages of their medications, decrease the number of medicines they are on or in a lot of cases completely stop their medication as it is no longer required. The same effect occurs in most individuals who suffer from high blood pressure.
Not to mention a percentage of people who manage to reverse sleep apnea, decrease pressure on their joints and live pain free or improve their fertility if suffering from polycystic ovaries.
The positive psychological effect of bariatric surgery
Myself and other surgeons are not blind to the real reason why a lot of people have bariatric surgery.
The majority come to see me for cosmetic reasons and who would blame them? It is really beneficial to an individual’s psychology to look and feel good. Dropping several dress sizes, being able to shop normal clothes stores and looking good in photos are sometimes the real reason people come to see me.
Things that lots of people take for granted such as being able to cross ones legs, or walk to the car park without feeling short of breath can become achievable goals for individuals suffering from obesity.
Not to mention the boost to confidence, self-esteem and positive outlook on life which usually accompanies weight loss following surgery and can lead to improved job and social prospects.
I always say that surgery is a win-win situation where the surgeon and individual both get the outcomes they aspire to in the right conditions.
When you arrive for your initial consultation with me, remember that this is really an informal chat about your health, lifestyle and dietary patterns with a view to work out if and what intervention is best for you.
There is no obligation to continue the journey and lots of time to think about the various options before committing.
It is also a chance to clear your mind and get into the right mindset for the changes that will come if you proceed.
Remember that the intervention is only a tool that works if you commit to changing the way you eat and your activity levels. There is no guarantee for weight loss.
Once you have decided to go ahead, there are a few members of my team that you will need to talk to which usually includes a dietician/nutritionist, psychologist, nurse specialist for pre-assessment and an anaesthetist.
The strength of a weight loss service relies on whether you have regular access to these specialists before and after the procedure.
Some services will only offer these appointments if you need or ask for them and some don’t offer them at all. Having this essential support in place is one of the main proponents of success with weight loss interventions.
This support is non-existent in overseas services which advertise at a low cost. Additionally, UK surgeons are baffled by overseas package prices that are so low they would not cover the price of the disposable equipment used for the procedure and wonder where the cost savings are made.
Needless to say, it is vital that you choose a service where you are sure you can talk to your nutritionist and psychologist before and after the procedure.
Liver shrinking diet
Once you have had all your pre-surgery appointments and tests, you will need to go on a special diet to shrink the liver before surgery.
Any surgery involves working on the stomach area high up under the diaphragm where it joins the gullet.
This area is covered by the left side of the liver. With obesity, fat deposition invariably occurs in the liver which makes the organ swell and become harder and more brittle.
To perform the procedure, it needs to be pushed out of the way with a liver retractor. And with a fatty liver this may not be possible or even lead to liver injury.
The diet, which is usually 2 weeks, is designed to reduce calories and fat intake to make the liver smaller or softer and preferably both.
This will hopefully be the last diet you go on which is also time limited with a goal at the end.
Most people fail their diets and suffer weight regain because diets are not sustainable in the long term.
It is really important that you stick to this diet religiously, as non-compliance can lead to canceled surgery on the day.
Those two weeks are also a wonderful opportunity to practice getting into the right mind-set for the procedure by removing all calorific food stuffs from your home. Now you are ready!