Patient Information (Bariatric)

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Bariatric surgery is the name given to a number of surgical procedures that are performed to help people who are very overweight and are often unable to maintain weight loss through diet and exercise alone to lose a significant amount of weight.

Bariatric surgery works by helping people to reduce portion sizes and the amount of nutrients and calories absorbed. This coupled with healthy eating and lifestyle changes will ultimately improve their health, reduce/eliminate medication requirements and hopefully help improve their quality of life.

The three main surgical procedures carried out by the Sheffield Bariatric Surgery Service (gastric bypass, sleeve gastrectomy and gastric band) are carried out laparoscopically (keyhole), wherever possible.

Bariatric surgery can work in two ways: Restrictive and Malabsorptive. The difference are;

  • Restrictive – the size of the stomach is made smaller (gastric bypass, sleeve gastrectomy and gastric band) so less food can be eaten resulting in weight loss
  • Malabsorptive – some of the food eaten is not absorbed into the body, it instead passes through resulting in weight loss (gastric bypass)

Weight loss is greatest during the first six months where losing about a stone a month is common. Weight will usually continue to fall a little slower until about one year to eighteen months after the operation. At this point, some weight regain is possible but further weight loss can be achieved through further dietary or exercise changes. By working closely with the bariatric team, patients can successfully and safely become a healthier weight, thereby reducing or preventing obesity-related medical conditions.

Bariatric surgery can be a very useful tool for those who struggle to lose or maintain a healthy weight. A reduction in weight can often result in a reduction in obesity-related conditions and medications for these, such as type 2 diabetes, high blood pressure, sleep apnoea, arthritis and joint problems. A healthy weight can also reduce the chances of these conditions occurring in the future. A large number of patients with type 2 diabetes will find that they do not need insulin immediately after or very soon after a gastric bypass operation due to re-routing of the bowel.

After surgery you will be given the email address for the specialist nurse and bariatric dietitian. You are encouraged to contact with any queries or concerns no matter how great or small. Depending on your query we can either email you or call you back. Please remember to include your name, date of birth, hospital number/NHS number (if known) and reason for query. We will try to get back to you within 48 hours. You will be contacted by telephone 2 weeks after your operation so that your health care team can assess your progress.

Most bariatric procedures are performed laparoscopically (keyhole surgery). The surgeon blows air into your abdomen so that he/she has a good view. You may feel quite bloated when you wake up. This will settle over a day or so.

Your wounds will either be stapled together with small metal clips or glued. It is important that you try to keep your wounds dry for the first week to promote healing. After this it is ok to have a shower or a bath.

Do not drive if you are taking pain killers and feel drowsy. Insurance companies may refuse to meet a claim if they believe you have driven too soon.

You will need to self -administer a blood thinning drug in injection form for 10 days after your operation. You will be taught how to do this whilst in hospital. This helps prevent the formation of deep vein thrombosis (DVT: clots in the veins in your legs).

You will struggle to swallow large tablets after surgery and so, until you are able to tolerate textured food (approximately 4 weeks post op), any medications should ideally be taken in liquid, dispersible or crushable form. You should discuss this with your GP before coming into hospital.

You will be advised to stop taking non- steroidal anti- inflammatory drugs (NSAIDs) as they can irritate the stomach and cause ulceration.

If you have had a gastric bypass or sleeve gastrectomy you will be prescribed Lansoprazole FasTabs 30mg once daily, which you will need to take for 3 months after your operation. This dissolves on your tongue and is a drug which limits the amount of acid your stomach produces and protects against stomach ulceration whilst your new stomach is healing.

Medication for diabetes may be reduced or stopped after your operation depending on your blood sugar readings. Likewise, blood pressure medication requirements will change. It is important that you have your blood sugars and blood pressure monitored regularly by your GP/practice nurse/diabetic nurse.

Some bariatric surgery patients already have, or may develop, nutritional deficiencies. It is very important that you take a daily multi vitamin and mineral supplement lifelong. These are available over the counter in chemists and supermarkets. If you have a gastric bypass or sleeve gastrectomy you will also need to have 3 monthly vitamin B12 injections for the rest of your life.

You will need to follow a very strict dietary plan, working through the 4 stages at a slow pace so as to help your new stomach heal and prevent vomiting. You will be given more details about these stages by your bariatric dietitian and specialist nurse.

You are likely to become constipated following bariatric surgery. This is because you will be eating much less than you could previously. Also your fibre intake is likely to be low and many people struggle to take an adequate (approx. 2 litres) of fluid each day. Your health care team will discuss this with you in more detail and give advice on laxatives to help things along.

Once you start feeling better it is important to introduce gentle exercise such as walking. As you start to lose weight you will have more energy and will be able to undertake more exercise: it is important to increase your activity levels in order to maximise your weight loss. Sexual activities may be resumed once it is comfortable for you.

You should avoid alcohol for a year following weight loss surgery. Alcohol can harm your liver and may irritate the stomach. It is extremely high in calories and is an appetite stimulant so you may be likely to snack or eat more. You will also feel the effects of alcohol much more quickly, particularly if you have had a gastric bypass.

Bariatric surgery is a tool not a cure: its success depends on you. The health care team are here to help and support you. You will need to attend regular follow up appointments for 2 years post surgery so that they can assess your progress and pick up any potential problems. However, it is you who make the dietary and lifestyle choices and implements the changes. Bariatric surgery is for life.

In addition to the specialist nurse and dietitian, a clinical psychologist also has a clinic to help patients adjust to changes following bariatric surgery and to assist in the management of any ongoing eating or weight related difficulties

The gastric band is a tool to help you lose weight by controlling portion sizes. The gastric band is placed around the upper portion of the stomach creating a small pouch.

It can be adjusted (fluid added or taken away) in order to help you reduce the amount of textured food you can eat at any one time before you feel full. The aim is for you to have 3 tea plate sized portions of textured food per day.

Your stomach is not cut nor is any part of your stomach removed.

The gastric band will not stop you from snacking or prevent you from eating high calorie, ‘easy go down foods’ such as ice cream, crisps, biscuits, cakes and chocolate.

You will usually go home on the same day or spend 1 night in hospital following gastric banding surgery.

All surgery (regardless of type) is associated with risks. For the gastric band this includes: vomiting if portions are too large, food is not chewed properly, or if food and fluid are taken together. The small pouch can stretch, which may then affect your oesophagus (food pipe). The band can slip; this may require further surgery for 10-20% of people.

The gastric band is designed to remain in situ for life however, 20% of gastric bands are removed worldwide because of problems.

It is very important that you attend your clinic appointments and follow the advice given to you by your health care team, both pre and post operatively, to ensure a safe and successful weight loss: this will reduce the chance of problems occurring.

The sleeve gastrectomy works by making the stomach smaller.

The stomach is divided and approximately 75% is removed completely. The remaining stomach is roughly the size of a banana. This limits the amount of food you can eat and therefore will make you feel fuller quicker.

You will usually stay in hospital for 2-3 nights following a sleeve gastrectomy. It can take from 3- 6 weeks for you to fully recover and be able to resume normal activities.

All surgery (regardless of type) is associated with risks. For the sleeve gastrectomy this can include: leaking from the staple line, bleeding, stricture, hernia and nutritional deficiencies. Vomiting can occur if you progress through the dietary stages too quickly, if your portions are too large, if food is not chewed properly, or food and fluid are taken together. These risks will be discussed with you further by your bariatric health care team if you decide you wish to be considered for surgery.

It is very important that you attend your clinic appointments and follow the advice given to you by your health care team, both pre and post operatively, to ensure a safe and successful weight loss: this will reduce the chance of problems occurring.

This service is available at the following Hospitals: