Obesity: when to go for surgery

Bariatric surgery aims to surgically treat obesity in patients and is now commonplace in hospitals throughout the world. One of the leading types of bariatric surgery is the gastric band procedure, which serves to control how much food an individual can eat.

Gastric band surgery is not necessarily the best option for all patients, however, which is why it is important to highlight the circumstances in which a decision to undergo the procedure should be made.

Gastric banding, gastric band surgery or laparoscopic adjustable gastric band surgery all describe the same procedure: the surgical insertion of an inflatable silicone band around the upper portion of the stomach. Installed using laparoscopic surgery, often referred to as keyhole surgery, the gastric band serves to constrict an area of the stomach with the aim of creating an upper pouch or reservoir.

Any food that is eaten by the gastric band patient passes into this upper pouch before moving slowly into the lower section of the stomach, where it is eventually digested. The purpose of the gastric band is to control how much food the patient can comfortably eat. Because food builds up more quickly in the upper section of the stomach, the patient is expected to feel full much more quickly than would normally be the case.

Aiming to encourage the patient to stop eating at this point, the feeling of fullness ultimately serves to reduce the amount of food that an individual can eat at a single sitting.

Gastric banding is a minimally invasive bariatric procedure that differs from popular forms of cosmetic surgery such as liposuction in so far as it does not remove fat but instead aims to remove the desire or compulsion to overeat. Gastric band surgery is a forcible push in the right direction when subtle prods and nudges have failed.

Gastric banding is by no means suitable for all patients. Generally speaking, consultant physicians would only consider gastric band surgery as a viable option if the patient in question has a BMI of 40 or more. BMI refers to the Body Mass Index, an international measure of weight to height ratio (the higher the BMI, the more obese the patient).

In some cases, surgeons will recommend gastric banding for patients with a BMI of 30-40, but usually only if there is a compelling medical reason to do so (for example, if the patient is struggling with diabetes).

Gastric band surgery should not be considered unless the patient has made genuine efforts to lose weight naturally through dieting and exercise. Failure to attempt these most basic and effective of solutions might suggest a general lack of will-power. Unfortunately, gastric band surgery does not provide patients with a free pass to being thin.

This is an important point to note. Gastric band patients continue to control precisely what and how much they eat after surgery; although the feeling of fullness can prove overwhelming in most cases, patients must follow post-operative diet plans without exception.

Deciding whether gastric band surgery is the right choice in the circumstances requires the help of experienced, fully qualified physicians, such as those at The Hospital Group. Consultants are able to explore all available options with obese patients, some of whom will no doubt benefit from gastric band surgery.

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