Bariatric surgery: the pros and cons

Broadcaster Jenni Murray claims her life has changed for the better since she has a gastric sleeve implanted to vastly reduce her appetite and consumption.

Some five stone lighter after years of obesity, the Woman’s Hour presenter feels fitter, more active and free of the vast overeating that blighted her happiness for so long.

Jenni, 65, paid £10,000 for her procedure which means she’s likely to vomit if she overeats. But many others get similar operations for free as the National Institute for Health and Care Excellence (NICE) who advise the NHS on best practice, recommend bariatric surgery for people with a BMI of 40 or more.

They also recommend NHS surgery for those with a BMI of 35-40 providing they have a co-existing health condition, such as type 2 diabetes or high blood pressure.

Needless to say, with an increasingly cash-strapped NHS, this is a provocative issue.

But money aside, if bariatric surgery is a quick fix for being fat, why bother with diets at all? Why don’t we all just save up and go under the knife?

It’s not as simple as waving a magic wand

Well, typically, if something is too good to be true, it requires further investigation.

Broadcaster Anne Diamond didn’t fare so well as radio chum Jenni. Despairing of her 15st 10Ibs frame, in 2005, she secretly had a gastric band fitted at a hospital in Belgium. She initially lost ten pounds but then found she could eat as much as ever. Said Anne: “I became convinced that I must be the only person on the entire planet for whom the gastric band just didn’t work. I’d failed at slimming yet again. Perhaps I was destined to become a fat old lady. I hated being unfit, having to wear big, shapeless clothes.”

Eventually, Anne went to another surgeon in London who told her the band had not been positioned correctly – and wasn’t even stitched in place.

She swiftly has the procedure corrected, but still, it wasn’t necessarily the magic wand she’d hoped for.

“I reduced by a dress size a month and lost about 3st before my weight reached a plateau, and now I’m having to work hard to keep the momentum going. It’s frustrating, but it’s better than being 15st 10lb.”

Tackling mind and body

While bariatric surgery dramatically helps many people go on to have fitter, more fabulous lives – there are plenty who still remain overweight or obese.

Research suggests around 20 per cent of individuals will find ways round the procedure, such as continually snacking or consuming very high-calorie foods.

Plus, for those of us who are exceptionally large, going under the knife could mean not waking up from the aesthetic which is why doctors often require candidates to lose several stones before being deemed fit for the operating table.

The other inescapable fact is that bariatric surgery has been shown to be potentially damaging to mental health – as opposed to losing weight the traditional way, which tends to lead to more long-term happiness.

Alarmingly, some studies show that obese patients who’ve had bariatric surgery are actually at higher risk of suicide than those who have not. Other pieces of research has also shown a 50 per cent increase in drug and alcohol addiction post surgery.

So, how could this be? Psychiatrist Dr Max Pemberton spares no punches about his view of the situation.

“In my professional experience, surgery of this kind is not only risky but can spell emotional disaster for obese patients. Why? Because it addresses only the physical symptoms of obesity (appetite) and totally disregards the most important tool of all – the mind."

Dr Max Pemberton

“It’s the mind that makes associations between what we eat and our emotions, between food and reward, or a sense of comfort.”

Dr Pemberton adds: “Over the years I’ve treated many patients who’ve had gastric bands. Many tell me they feel as if they’re being mentally tortured. I believe this is because individuals are forced to look for alternative crutches to provide the comfort that food used to provide.”

The fact is losing weight isn’t just about biology. It’s about shifting our perceptions.

Many obese people take time to adapt to their slimmer new selves, they need support and understanding.

Company boss Julie Moakes, 54, spent a total of £12,000 on three gastric procedures and her put health and wellbeing in considerable danger.

During her first operation, to fit a gastric band, surgeons found Julie’s liver was exceptionally swollen and she was told to lose three stone before they could give the operation a second go.

The next operation was a success, with Julie going on to lose 4stone but then the band suddenly began to push through Julie’s stomach lining. She found herself doubled over in pain vomiting black fluid. Having been rushed to hospital, surgeons replaced the band with a non-reversible gastric bypass which reduced her stomach to a small pouch.

This did little to deter Julie from overeating…and before long her weight shot back up to over 21stone.

Defeated and traumatised, Julie finally decided to throw the towel in and sign up to a weight-loss programme with group work.

It was then she was shown a series of brilliant mind tools to help her manage her weight differently. She subsequently lost around ten stone.

“The gastric band and bypass dealt with my body, not my brain. They stopped me from eating for a while, but they didn’t change my attitude, so it was never going to work,” reflects Julie.

“In the group, as I listened to other people talk, I realised just how much I’d been lying to myself – and my friends and family about my eating. I also learnt how to recognise when I needed food and when I just wanted it.”