Do I qualify for bariatric surgery?

The primary indicator used by bariatric surgeons to assess a patient’s suitability for bariatric surgery and to monitor post-procedure weight loss is their body mass index (BMI). This is used to determine if a patient has a healthy weight. We asked Mr Ali Alhamdani about suitability for weight loss surgery and all about the benefits and the costs.

The National institute of clinical excellence (NICE) in the UK, recommend bariatric surgery for:

• Any patient with a BMI of 35 kg/m² with medical problems related to obesity like; hypertension, sleep apnoea, polycystic ovarian syndrome, and type 2 Diabetes.
• Any patient with a BMI of 40 kg/m² with or without medical problems related to obesity.
• Patients with type 2 Diabetes with a BMI of 30-35 after medical treatment has proved unsuccessful and with the recommendation of a team of endocrinologists.

Dr Alhamdani believes that every patient is unique, therefore, it’s important to carry out a detailed assessment of the patient, before performing weight loss surgery. The assessment should take into account the patient’s medical history, weight and height. Weight is not the only factor bariatric surgeons look at when assessing a patient’s suitability for a weight loss procedure. This is because there is no set weight; for example, a taller individual will be able to carry more weight comfortably, compared to a shorter individual.

Dr Alhamdani makes the final decision for surgery based on:

• The patient’s eating habits
• Patient’s medical history
• Patient’s social and psychological background

At present in the UK, the national health system has limited funds available for weight loss surgery, but there is an increasing number of patients that require this surgery. The decision to fund the surgery depends on the local clinical commissioning group (CCG), and on the patient’s post code. In some UK regions, the majority of obese patients will be referred to bariatric surgery, while other CCGs will refuse referral due to the limited funds available for that region. In other words, receiving funding is a post code lottery.

In addition, the NHS now recommend that all patients have to spend 12 months in a weight loss management centre before they can qualify for surgical intervention. This is a weight management option to treat obesity, but will further delay the NHS patients getting their surgery for 12 months.

How quickly will I lose weight after bariatric surgery?

Weight loss after bariatric surgery will happen in the first year following the procedure. The patient will lose two-thirds of the weight in the first 6 months and the other third in the second six month period. After the first year, weight loss usually stops. The amount of weight lost will depend on the operation had. The average weight loss following a laparoscopic sleeve gastrectomy is 60%, while with a laparoscopic gastric bypass, the average weight loss will be 80%.

After the first year, the patient will have learnt new eating habits and will be under the supervision of a dietician and a specialist bariatric nurse who will help them maintain good eating habits and physical activity to maintain the weight loss.

What is the cost of weight loss surgery?

I fully understand what people go through when they are overweight, the difficulty of making the decision to have bariatric surgery and the post-operative care needed for every patient. Included in the price, my patients will receive five years of aftercare provided by our surgical teams who have carried out over 4,000 weight loss procedures.

All our fees are covered within the package prices detailed below:

Please note: all prices stated are for UK residents only for the operation to be performed in BMI Clementine Churchill Hospital. Please inquire for international prices and Wellington Hospital fees. All our prices are subject to your initial consultation with your consultant. The final package price may vary to reflect any medical history that may require further investigation prior to your surgery, any complex medical history if you have a BMI over 50 and your chosen location. I will discuss these with the patients and all costs will be clearly explained in advance of any procedure.

Packages include:

• A private room in one of our centres
• A one to one consultation with myself
• Five years aftercare that includes follow up appointments with members of our expert teams, including; surgeon, nurses and dietitians.
• Access to our 24/7 advice line for two years
• Access to non-urgent email dietetic advice service (not 24/7) for two years
• 30-day post-surgery complication cover

Finance packages:

We offer flexible financing packages to help make your procedure more affordable, with monthly repayments.

Can bariatric surgery really help diabetes?

An increasing amount of evidence favours the effect of surgery on type 2 diabetes in comparison to other methods of treatment like medication, diet and exercise. Evidence shows that obesity surgery attacks the symptoms, in addition to the cause of diabetes. After surgery, diabetic patients have their blood sugar normalised within just a few months. They also have less of a chance of developing diabetic complications like blindness and heart disease. Surgery also helps to reduce high blood pressure and lower high cholesterol levels.

Why does surgery have this effect?

Even though we’ve been observing the effect for over 60 years, the truth is we still don’t know how this operation works exactly. One theory is that because the patient loses weight, the body cells’ sensitivity to insulin increases. Another theory is that gastric bypass surgery encourages the production of certain intestinal hormones, which increases the production of insulin. A third branch of thought is that the procedure interferes with the absorption of bile acids and salts and decreases the absorption of harmful sugars and carbohydrates.

It is absolutely a game-changer. All of the medical treatments we have for diabetes don’t tend to cure the disease itself but keep the symptoms partially under control. The notion that you can actually cure the condition is ground-breaking.

It’s also a game-changer when you think about it from the perspective of cost. We currently spend £3,000 - £4,000 a year treating someone with diabetes. A gastric bypass costs about £10,500. If it’s successful in curing the patient of diabetes, it will pay for itself within just two years. When you consider that there are up to four million people in the UK with type 2 diabetes, that’s an enormous cost saving.

What are the benefits of treating diabetes with surgery?

Other than the health benefits and diabetes remission for patients, studies have shown the economical benefits. In the long run, it’s more economical to pay for surgery than to spend money on medication year after year.

The UK National Bariatric Surgery Registry (NBSR), which conducts a continuous auditing process of the result of obesity surgery in the UK, showed that diabetic people who received surgery had a 75-80% chance of diabetes remission.

If you’re interested in knowing more about bariatric surgery and it’s benefits, head over to Mr Alhamdani’s profile to read more articles or to make a consultation.