W MEDICAL
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WEIGHTLOSS THROUGH A KEYHOLE
BY CONOR MCGEE
The clocks have gone forward, which can only mean one
thing- Summer is a-coming. Alongside Summer our thoughts
naturally turn to holidays. The ritual of choosing a place to
go, who to go with and, of course, what to wear. There can’t
be many of us that haven’t tried to lose some weight just to fit
into that new swimming costume!
For most people this means losing a few pounds- usually by
cutting out naughty foods and perhaps indulging in some
exercise.
But what if you needed to lose a stone? OK- let’s start a proper
diet and regular exercise. But how about 5 stones? What about
10 stones, 15 stones- what would you do if you needed to lose
20 stones…or even more?
It is an unfortunate fact that severe obesity (properly termed
morbid obesity- because of it’s serious effects on health) is a
huge problem both here on the Wirral and across the United
Kingdom. Right now there are over nearly 2.5 million people
in the UK with a body mass index (BMI) greater than 40 (a
normal BMI is between 20 and 25). This is a huge problem;
because morbid obesity is associated with severe, expensive
health problems, notably type 2 diabetes. The NHS spends
around 1.25 Million pounds per day in treating diabetes- and
the biggest driver of diabetes is severe obesity.
Unfortunately, severe obesity cannot be wished away by a
combination of “eating less and moving more”- the science
shows that whilst fat is easy to accumulate, it is very difficult
to lose, as anyone who has been on a diet (and another diet,
and another diet…) will know this. Imagine if there was a safe,
reliable, cost-effective way to lose weight and treat diabetes and
heart disease…
As a junior surgeon I was trained to treat and remove cancers
of the stomach and gullet. These are awful diseases with poor
outcomes despite surgery. Clinics were a sobering experience,
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often delivering bad news to frightened patients. However,
I did notice a rather unusual clinic across the way from
the cancer clinic. It was unusual in that some patients were
markedly overweight and some were not- but what struck me
was the positive atmosphere, people were happy to be there.
I investigated further and found that this was the bariatric
(obesity) surgery clinic. The bariatric clinic was so positive
because patients were losing weight and getting cured of their
diabetes and other conditions- and that was how I started on
my journey to be a bariatric surgeon.
I mainly perform two operations: the gastric bypass (involves
creating a small stomach pouch and re-routing the intestines
to reduce the amount of food eaten and altering the body’s
hormone levels to allow diabetes to enter remission) and the
sleeve gastrectomy (removing the outer two-thirds of the
stomach to create a much smaller banana shaped stomach
that also reduces hunger hormones). These operations are
performed through tiny keyhole incisions- nearly all patients
can go home after two nights in hospital, even those who weigh
30 stones or more!
Patients will lose around 70% of their extra weight- far in excess
of any other treatment. More importantly I expect diabetic
patients to go into remission- they will no longer need their
diabetic medications! The operations induce profound changes
in eating behaviour. This is not just because we have made the
stomach smaller but also because the operations change the
brain- for example patients can find they have no longer crave
chocolate and sweets and prefer healthier food options.
I now have a clinic that is full of happy patients - they tell
me the surgery has given them their life back. It is a moving
experience- a true privilege as a surgeon.
Mr Magee is on Twitter (@mageefrcs) and can be consulted at
Spire Murrayfield Hospital. For more information visit:
www.phoenix-health.co.uk