Gastric Surgery and Obesity

Is bariatric surgery the answer to the UK’s obesity epidemic?

According to an article by Nick Triggle published on the BBC News website “millions of pounds is lost in England by the failure of the NHS to provide more obesity operations”.

“About 1million people meet the criteria for bariatric surgery, but last year there were just 3,600 operations carried out”.

It’s suggested that around £1.3bn could be saved over three years if only a quarter of eligible patients were treated with bariatric surgery through less working days being lost and fewer demands on the NHS according to The Office of Health Economics.

But does this mean that gastric surgery is really the answer?

Firstly, I think it’s important to point out that as sated in the article the research was funded by two firms involved in making equipment used in obesity surgery.

This is the equivalent of asking companies that make orthopaedic surgical equipment how to save money on road traffic accidents. Safer roads, cars and drivers are surely better options than facial reconstruction surgery, however good it is!  No one would ever drive the wrong way up a motorway just because research funded by surgery equipment manufacturers suggested that surgeons will be able to fix all the injuries sustained through a head-on collision (if they were lucky enough to survive that is). In the same way, to suggest that just because surgeons can perform operations to help people lose weight is  a reason to sit by and watch people to become so obese as to damage their health and risk a premature death is ludicrous?

Another problem is that any research project that’s funded by companies who have a direct financial gain in the outcome surely brings up serious issues relating to a conflict of interest.

Secondly, what is the criteria for bariatric surgery?  It’s obesity!
Thirdly and most importantly, What is obesity?

If we are to ever stem the rise in the number of people becoming morbidly obese then we really have to accept the fact that obesity is NOT an illness, injury or disease, it’s a preventable condition caused through overeating and lack of exercise.  There is nothing complicated about the mechanics of weight loss or weight gain; it’s a simple equation of calories in vs calories out.  If a human body (or any other animal for that matter) takes in more energy (calories in) per day than it uses up through burning energy (calories out), those calories are stored as fat.

Dr Hamish Meldrum, the head of the British Medical Association says that the obesity epidemic is being mistakenly targeted with medical treatments and he believes the obsession with medical labels may be stopping overweight people addressing their own problems.

“People like to put fancy labels that suggest things are a medical problem.” “We are in danger of over-medicalising.” “ The evidence for effective intervention in primary care for obesity is very weak.”

As stated earlier, “obesity is NOT an illness, injury or disease”. Obesity does however cause illness, injury and disease in the form of:

• Cancer: Gallbladder – Breast, uterus, cervix, and ovaries (in women) and colon, rectum, and prostate (in men)
• Diabetes
• Gallbladder disease and gallstones
• Gout
• Heart disease and stroke
• High blood cholesterol and high blood pressure
• Complications during pregnancy and irregular menstrual cycles
• Osteoarthritis
• Sleep apnoea

To name but a few!

Dr David Haslam of the National Obesity Forum, which commissioned the research along with the Royal College of Surgeons, said the government needed to improve access to treatment – why?. What is the evidence that surgery is the only or the best option. Peter Sedman, a bariatric surgeon and member of the Association of Laparoscopic Surgeons, added: “Surgery can literally transform people’s lives in a way that no other treatment is able to, getting them back to work and contributing fully to society.”  What an incredibly arrogant and misleading statement.

There are hundreds of therapists in this country doing amazing work to help people lose weight and change their lives forever.  Much of that work is putting right the physical and psychological damaged caused by years of obesity and dieting and finally, needlessly cutting open patients and restricting a perfectly healthy digestive system.

Dr Meldrum said: “I am not saying we should not look at how we can medically treat people who are very obese. But to me it is obviously an issue where prevention is better than cure.”

However, Colin Waine, chairman of the National Obesity Forum, said: “How can obesity not be medicalised if there are 45 core morbidities associated with obesity and overwhelming evidence of a causal link?”

I would suggest that Colin Waine is completely missing the point here and that by making obesity a medical condition we are removing not only individual responsibility for our own health but also the option for any non-medical treatment.  “I over eat because I have a medical illness so there’s nothing I can do.”  Obviously the medical conditions created by obesity, such as cancer, diabetes, heart disease and stroke greatly benefit from medical intervention but obesity in itself is NOT an illness.

I wonder where the National Obesity Forum, Association of Laparoscopic Surgeons and people like Dr David Haslam, Peter Sedman and all other highly paid bariatric surgeons would be without the need for gastric surgery for obesity?

If, as The Office of Health Economics suggest, £1.3bn could be saved over three years by treating only 25% of obese patients who currently meet the criteria for surgery, imagine how much would be saved if 90% of “all” obese people in the UK were given the help needed to control their weight in the first place. The figure would run in to £10′ billions. Even more money would be saved by preventing those who would have become obese from ever becoming overweight in the first place.

Over the last few years I have treated several post gastric band op patients who, despite the surgery (or perhaps because of it), found they were still putting on weight.  How is this possible? Surely if a persons stomach has been reduced in size they will not be able to eat as much food as they did before the operation?

The problem is not the volume of food eaten but the quality and quantity of the food eaten.  Every client I have seen tells the same story; since their operation, whether they want to or not, unless they liquefy their food they are no longer able to eat healthy foods such as wholemeal bread and pasta, lean meat (including chicken and fish), even vegetables and fruit simply will not go down and they end up vomiting it back up.  Instead and cruelly ironically they end up eating junk food which turns to mush in the mouth, is easily digested and does not cause vomiting, such as potato snacks formed from potato starch, chocolate and ice cream. In fact one client told me his post lat band diet consisted entirely of Pringles, chocolate and coke (apparently the coke was good for bringing up the gas he had suffered from ever since having the band fitted).

Many of these patients are not only suffering from the horrendous physical and psychological side effects of the surgery but are now also having to cope with the added stress and anxiety caused by the fact that they are still putting on weight.  This is made even worse by the fact that as much as they would like to have the bands removed, they simply can’t afford the procedure.  Perhaps it’s time for the companies and surgeons who “sell” bariatric surgery to put their money where their mouths are and offer a full money-back guarantee and free reversal procedures to any patient not completely satisfied.

It is the view of the Department of Health that bariatric surgery should only be a used as a “last resort” and that people should be encouraged to pursue healthier lifestyles so this type of treatment was not necessary.  Now it’s not often I agree with government policy when it come to health-care but I do agree that gastric surgery such a gastric bands (lat bands) and gastric bypass operations should only ever be considered as a “last resort” and that a healthier lifestyle is the best way of avoiding becoming obese in the first place.

In both the long and short term, the problem of obesity is not something that can be cured through surgery. The idea that treating obesity by cutting bits off and tying bits up is a nonsense.  If a patient was admitted to hospital with head injuries because they could not stop banging their head against the wall, would the doctor treat them by removing their head?  The same is true of obesity.  It’s the patient’s relationship with food that is the problem. By helping patients to change their relationship with food with techniques such as Virtual Gastric Band hypnotherapy the need for gastric surgery becomes obsolete.  The only people who gain from gastric surgery are the surgeons and the companies who supply them.

Weight gain and weight loss is a matter of individual responsibility and the best way to help a patient take on that responsibility and gain control over their lives is through therapeutic intervention, not surgery.

For more information about how Virtual Gastric Band hypnotherapy can help you lose weight and keep if off,  call 07825 654377 or click here for the contact form.