Weight Loss Surgery

Weight loss surgery and adapting to life after surgery is a challenging process, requiring the input of many different medical professionals working together as a team.

This is known as a multidisciplinary team (MDT) and it may consist of:

• a surgeon
• an anaesthetist
• a dietitian
• a psychologist
• a gastroenterologist (doctor who specialises in treating digestive conditions)
• a specialist weight loss surgical nurse,who will usually be your first point of contact

Most MDTs operate out of specialist bariatric surgery units, which are typically based in larger hospitals.

Before your weight loss surgery can take place, you shouldbe referred to your nearest specialist unit for an assessment, to see if you're a suitable candidate for surgery.

Assessment

Your assessment may consist of three main phases:

• physical assessment
• psychological assessment
• nutritional assessment

You should be given information on the reason for these tests, how they'll be carried out and the meaning of any results.

Physical assessment

The purpose of the physical assessment is to check whether you have any health problems or other factorsthat could complicate your surgery.

You may receive the following tests:

• Blood tests
• an electrocardiograph (ECG), where electrodes are used to measure the electrical activity of your heart
• chest X-rays
• spirometer a machine that measures how well you can breathe in and out
• ultrasound scan this uses sound waves to build up a picture of the inside of your body and is useful for spotting conditions such as gallstones and non-alcoholic fatty liver disease

Psychological assessment

The psychological assessment determines whether:

• you have any mental health conditions or emotional problems that could prevent you sticking to your lifestyle plan after surgery
• you've developed unhealthy patterns of eating, such as binge eating , that could cause problems after surgery
• you have realistic expectations of what life will be like after surgery

The process of assessment can differ between units, but it's likely you'll be asked questions about:

• how obesity is affecting your emotions
• how obesity is affecting your relationships with others
• how obesity is affecting your daily activities
• whether you're currently taking medication or seeking treatment for a mental health condition
• your current pattern of eating and your willingness to change the pattern after surgery
• what benefits you expect surgery to bring you and how you feel your life will be after surgery

Having a mental health condition such as depression or an eating disorder doesn't automatically mean you're not suitable for surgery. However, surgery may bedelayed untilit's under control.

Nutritional assessment

The nutritional assessment has two main purposes.

The first is for the dietitian to obtain a detailed history of your current diet and associated patterns of eating and how these have contributed to your obesity.

The second is to ensure you fully understand the dietary commitments you will need to make after surgery, which may include:

• improving the nutritional content of your meal
• eating small amounts of food slowly rather than rushing through a meal as quickly as possible

Your dietitian may also recommend a calorie-controlled diet for several weeks or months before surgery. This is because losing even a modest amount of weight before surgery is known to reduce the risks of complications, especially if you're going to have keyhole surgery.