Gastric bypass

·         Obesity is a major risk for not just diabetes and heart disease but many others. WHO says obesity is 2^nd only to smoking as cause of cancer

·         Loosing weight is not easy but very important. The more overweight a person is the greater the resistance to the actions of insulin.

·         Surgery for weight loss is called bariatric surgery. Not to be seen as an easy option. It is approved by NICE under certain conditions.

NICE recommends:

• this type of surgery should be considered only for people who have been receiving intensive management in a specialised hospital obesity clinic
• individuals should be aged 18 years or over
• there should be evidence that all appropriate and available non-surgical measures have been adequately tried but have failed to maintain weight loss
• there should be no specific clinical or psychological contra-indications to this type of surgery
• individuals should be generally fit for anaesthesia and surgery
• individuals should understand the need for long-term follow-up.

Surgery should normally be reserved for those with a BMI of 40 or more but NICE accepts that it may be offered to those with a BMI in excess of 35 if they have associated morbidities that may benefit from weight reduction.

·         Gastric bypass and similar operations are designed to make food bypass part of the gut and in doing so to reduce absorption.

·         The number of operations done in the UK each year is rising.

·         Laparoscopic techniques are being used more often (Tony, is laparoscopic bypass surgery feasible? I would doubt it)

·         The risk of surgery in people who are substantially overweight is much higher than in those of normal weight

·         Because the operation is designed to produce some failure of absorption of food, it may cause frequent and loose bowel motions. It may also lead to deficiency of certain vitamins and minerals such as calcium. It is probably wise to take a daily vitamin and mineral supplement after this surgery.

Gastric bypass, especially if with gastric banding also, is a much larger procedure but it does produce more weight loss. It is usually reserved for those with the most weight to lose.

This form of surgery should not be seen as a “magic bullet” to lose weight but in people who are severely overweight and who struggle with appetite, it has a place. Continued attention to weight with diet and exercise is a life-long process.

Dr Tony Woolfson MB BS DM MRCP(UK)
Learn how to master your diabetes.  Visit my website at www.diabetesdietdoctor.com.