Weight loss surgery on the NHS

Once an overweight person reaches a Body Mass Index of 40 or over they are referred to as morbidly obese. This dangerously overweight state can then be very hard to treat naturally. Having a BMI that big can make it difficult for someone to get about and to shed the pounds.

It may be necessary then for the patient to be referred for weight loss surgery. For some people with a slightly lower BMI of 35 to 40, weight loss surgery may be recommended if they also have life threatening conditions which could be improved by losing weight such as severe sleep apnoea, diabetes or heart disease directly related to obesity. Weight loss surgery on the NHS is available in some circumstances.

In order to avail of weight loss surgery on the NHS, there has to be a clear need for the surgery and all other means must have been unsuccessfully attempted. There are clear guidelines set down by the National Institute for Clinical Excellence (NICE) which must be adhered to before a patient can be treated for obesity on the NHS. These conditions state that the patient must have a BMI of 40 or over; a BMI of 35-40 if other life threatening conditions could be improved by losing weight; that all other natural treatments such as diet and exercise have been tried but failed; that the patient will commit to long term treatment and that the patient is fit and healthy and suitable for surgery.

The NHS uses three main types of weight loss surgery, gastric bypass surgery, gastric band surgery, and the intra-gastric balloon. Gastric bypass surgery involves a band being placed around the stomach to create a smaller stomach, which is then re-routed to the small intestine thus bypassing the rest of the stomach. A gastric bypass has a high risk of complications such as bowel obstruction, bowel or intestinal leakage, infection at the surgical site, lung infection, blood clots or internal bleeding. However, a gastric bypass procedure can be performed on those with a BMI of 45 or higher.

Gastric band surgery involves a band being fitted around the stomach in much the same way as a gastric bypass. Again a smaller stomach is created but instead of bypassing the rest of the stomach, this procedure allows for food to pass into the remaining part of the stomach but at a much slower rate through a tiny gap between the two ‘stomachs’. Gastric banding works by reducing the amount of food that you can eat. Gastric banding causes less complications than a gastric bypass but can still result in leakage or infection. It cannot be performed on people with a BMI of 45 or over.

An intra gastric balloon is a procedure that involves a deflated silicon balloon being placed in the stomach and then inflated. This results in the stomach feeling full. It reduces the amount you can eat as less food will fit in the stomach and you should not feel hungry. This is a short term weight loss procedure and the balloon is normally taken out after six months.

As long as you fulfil certain criteria, you should be eligible for weight loss surgery on the NHS but you could find yourself at the end of a long waiting list.

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