Is surgery the answer to your obesity problem?

How did you hear about weight loss surgery? Did you read an article in a magazine? Has your doctor recommended it to you? Do you know someone who has had it done? Whatever the reason, it is important that you learn and understand as much about this weight loss method as possible to ensure that it is right for you, and that you give yourself the greatest chance of success by being fully prepared for the road ahead. BOSPA's ethos is about empowerment, we want to empower you to make the right decision and to get the best out of your surgery.

Here's a very simple explanation of how you will lose weight with surgery. Your body needs energy to function and your energy source is the food that you eat. A normal weight person successfully balances their energy intake (food eaten) with their energy requirements (daily activity). In other words, they burn up all the energy provided by the food they eat, and stay slim. However, you began to get fatter when you started to eat more food than you needed for your energy requirements. Over a long period of time the excess has been stored as fat around your body. In theory, just 100 calories eaten more than you need each day would lead to a weight gain of 10lbs per year. Do that for 10 years and you could gain 100 lbs (over 7 stone or 45kg)!

A person who is roughly 30kg (65lbs) or more above their ideal weight is considered to be severely obese. However, obesity is a complex condition and not simply caused by overeating. In fact, most people in the UK eat more calories than they need, but not everyone stores the excess as fat. There seems to be some sort of in–built mechanism that causes excessive fat storage in some people, and scientists are working to try and understand more about it. Severe obesity tends to run in families so there is likely to be a genetic component as well.

Weight loss will only happen when your body has to burn up the stored fat to provide your energy. In other words, when your body's energy needs are greater than that provided by the food you eat. The changes bought about by weight loss surgery are a 'tool' to restrict your energy intake so that you will burn up your fat stores. Weight loss surgery is almost guaranteed to help you lose weight, but like all good tools, it works best in the hands of a worker (you) who is well trained!

Why being obese is such a health risk

Some people can be very overweight and not suffer any major medical problems – you may be one of them. However, the truth is that being overweight dramatically increases your chances of suffering a serious health problem in the near future (sometimes referred to as an obesity–related disease). Here are some scary statistics for you:

If you are obese you are:

  • 6 times more likely to develop gallbladder disease
  • 5.6 times more likely to develop high blood pressure
  • 3.8 times more likely to develop diabetes
  • twice as likely to develop arthritis
  • more likely to develop some cancers including prostate, breast, cervix and ovarian cancer
  • more likely to have a stroke
  • more likely to suffer back problems
  • more likely to be infertile
  • more likely to suffer depression
  • more likely to snore and suffer sleep disorders

And probably most importantly of all, your life expectancy is much shorter than that of a normal weight person - the more obese you are, the more risk you have of dying at an earlier age.

With all this data, isn't it amazing that, until very recently, it was really hard to find doctors who were willing to treat people with a weight problem. Fortunately the World Health Organisation has now classified obesity as a disease in its own right and this has led to governments and health professionals around the world improving the services provided to help treat obesity.

How overweight are you?

All over the world populations are becoming more and more overweight. To measure this, experts now talk about your BMI, or body mass index. This is calculated by dividing your weight in kg by your height in metres, twice. Here are some basic definitions for you:

BMI less than 18 kg/m² Underweight
BMI 18 - 25 kg.m² Normal
BMI 25 - 30 kg/m² Overweight
BMI 30 - 35 kg/m² Obese
BMI 35 - 40 kg/m² Severely obese
BMI over 40 kg/m² Morbidly obese
BMI over 50kg/m² Super obese
BMI over 60kg/m² Super–super obese

To find out what your BMI is click here

A study published in America in 2003 suggested that the optimal BMI for a white adult is 23–25kg/m² and for a black adult it is 23–30kg/m².¹

Obesity surgery patient selection

Surgeons undertaking weight loss surgery understand the importance of selecting patients who are likely to benefit most from it. The following criteria have been set by the UK government health advisory body, the National Institute for Clinical Excellence (NICE), to aid patient selection. It is unlikely that you will find a UK bariatric surgeon who is willing to perform an operation, even privately, on you if you don't meet these criteria:

  • BMI over 40 kg/m², or BMI over 35kg/m² and patient also has an obesity–related disease
  • Aged 18 or over (some centres set an upper age limit of 60)
  • The patient has tried other weight loss treatments without permanent success
  • There is no specific metabolic or psychological reason for the obesity
  • The patient has sufficient understanding of the procedure and the changes it will produce
  • The patient is strongly motivated to undergo the procedure and lifestyle changes it will entail
  1. Fonatine KR et al, JAMA 2003 Jan 8;289(2):187–93

To read the full NICE guidelines click here.