The Hospital Group are one of the first medical organizations to provide what are referred to as “balloon implantsâ€� – a new revolutionary weight loss treatment, ignored by the NHS, which could save thousands suffering from the effects of obesity and its associated diseases.

The Hospital Group, the UK’s leading provider of weight loss surgery, are set to insert silicone balloons into the stomachs of people who are over weight with a BMI of 30+ – making them eat less, feel full and re-learn eating habits over a period of six months.

The procedure is already popular in the States and experts are predicting it could provide the answer the Britain’s obesity crisis. Recent research shows that almost one in four adults are now regarded as obese and two thirds as being overweight.
As demand for weight loss solutions grow, The Hospital group predict that the gastric/silicone balloon could be the long awaited answer for short term weight loss. It is not, however, recommended for the morbidly obese – which Government watchdogs point as the reason why the NHS are turning a blind eye to such an effective weight loss treatment.

A new study from Brazil showed that patients who had this revolutionary treatment lost almost half their excess weight and with the gastric balloon suffered no side effects.

The gastric/silicone balloon is a non-invasive way of reducing the size of the stomach. A balloon is put in under sedation and the patient suffers only mild discomfort. Most patients say they don’t even feel that it is there. The objective of the balloon is to re-educate the patient about food and their relationship with it.

If patient starts to gain weight again they may require a gastric band or bypass. The gastric/silicone balloon is designed to act as a form of portion control allowing patients to lose weight whilst maintaining a healthy balanced diet.

Silicone balloon prices start at £3,950.
COSMETIC BLISS COMMENT – OUR BALLOON PRICES – FULLY INCLUSIVE OF FLIGHTS, ACCOMMODATION, REMOVAL AFTER 6 MONTHS AND ON-GOING SUPPORT AND AFTERCARE ARE ONLY £2,500 – WITH NO EXTRAS

Here’s an extract of a press release we saw this week.  It’s good to know Stomach Balloons are being more widely offered in the UK, but the cost is, as one would expect, significantly higher than in the Czech Republic. 

“PRIVATE SECTOR LEADS WAY WITH FAT BALLOON IMPLANTS – POSSIBLE CURE FOR OBESITY
The Hospital Group are one of the first medical organisations to provide what are referred to as “balloon implantsâ€� – a new revolutionary weight loss treatment, ignored by the NHS, which could save thousands suffering from the effects of obesity and its associated diseases.

The Hospital Group, the UK’s leading provider of weight loss surgery, are set to insert silicone balloons into the stomachs of people who are over weight with a BMI of 30+ – making them eat less, feel full and re-learn eating habits over a period of six months.

The procedure is already popular in the States and experts are predicting it could provide the answer the Britain’s obesity crisis. Recent research shows that almost one in four adults are now regarded as obese and two thirds as being overweight.

As demand for weight loss solutions grow, The Hospital Group predict that the gastric/silicone balloon could be the long awaited answer for short term weight loss. It is not, however, recommended for the morbidly obese – which Government watchdogs point as the reason why the NHS is turning a blind eye to such an effective weight loss treatment.

A new study from Brazil showed that patients who had this revolutionary treatment lost almost half their excess weight and with the gastric balloon suffered no side effects.

The gastric/silicone balloon is a non-invasive way of reducing the size of the stomach. A balloon is put in under sedation and the patient suffers only mild discomfort. Most patients say they don’t even feel that it is there. The objective of the balloon is to re-educate the patient about food and their relationship with it.

If patient starts to gain weight again they may require a gastric band or bypass. The gastric/silicone balloon is designed to act as a form of portion control allowing patients to lose weight whilst maintaining a healthy balanced diet.

Silicone balloon prices start at £3,950. For more information contact The Hospital Group, website: wwwthehospitalgroup.org or call: 0800 135 3055

Press Note: we do not have case studies yet as this proceedure is only being introduced through The Hospital Group this week. “

Laura Donnelly, Health Correspondent, Sunday Telegraph 12/08/07
Almost 700,000 people are so fat that they need drastic surgery to tackle their weight problems, the Government’s health watchdog has found.

Despite the scale of the obesity crisis, primary care trusts (PCTs), fearful that the £3 billion cost of the operations would cripple the NHS, are restricting surgery to the most desperate cases. Last year, fewer than 5,000 such operations were performed.

Analysis of the guidance drawn up by the National Institute for Health and Clinical Excellence (Nice) reveals that 688,000 people in England, classified as “morbidly obese”, are entitled to be fitted with gastric bands or to have stomach stapling operations to reduce the amount of food they consume.

Nice says that anyone with a body mass index (BMI) above 40 should be offered surgery if other attempts to lose weight fail after six months, and those with a BMI above 50 should go under the knife immediately. A BMI of 40 equates to a man of 5ft 9in weighing 19 stone and a woman of 5ft 4in weighing almost 17 stone.

However, obesity experts claim that PCTs are ignoring the guidelines and, because they cannot afford to pay for thousands of operations – which cost about £6,000 each – are imposing stricter restrictions of their own.

Critics said the figures were an indictment of the Government’s failure to tackle Britain’s obesity epidemic, which has seen the number of obese people soar by 40 per cent in the past decade. One Briton in four is now classed as obese.

Andrew Lansley, the shadow health secretary, said: “This is an illustration of the Government’s failure to tackle the problem. It shouldn’t be about waiting until someone becomes a hopeless case.”

Obesity experts said that cash-strapped PCTs were desperate to avoid the costs of operating on the obese.

David Hewin, a surgeon at Gloucestershire Royal Hospital, said: “The numbers involved are huge, so PCTs are coming up with much more stringent criteria and moving the goalposts. Some are only offering surgery to patients who have other medical problems, such as type two diabetes, and some only to patients with a BMI over 50.”

Janet Edmond, director of the British Obesity Surgery Patient Association, said budgetary concerns were being exacerbated by a shortage of the specialists required to perform the procedures. “At the moment this is being funded in small numbers,” she said. “I would love to see a lot more patients getting access to surgery but realistically it cannot be done overnight. The resources are just not there.”
 

By EMMA MORTON -The SUN
August 03, 2007
 
FAT Brits who want to lose weight should just eat less, a top doctor claimed last night.                                                                                        Obesity is now “over-medicalisedâ€�, said British Medical Association chief, Dr Hamish Meldrum. He said too many adults use pills and surgery to try to slim – instead of cutting out junk food.

Dr Meldrum said: “People use fancy labels that suggest things are a medical problem. It is preferable for people to change their eating habits.�

Weight-loss surgery — like gastric bands — has risen six-fold in ten years, with 1,000 Brits having the op each year.

Slimming pill sales are also up with more than £48million a year spent on tablets.

COSMETIC BLISS WOULD WELCOME COMMENTS ON THIS ITEM

Here is some information from NICE (National Institute for Clinical Excellence) which puts the above comment into perspective, we think.  If the morbid obesity epidemic was able to be solved by the simple expedient of eating less, there would be no problem:

According to NICE, in 1998, an estimated 0.6% of men and 1.9% of women in England and Wales had a BMI of 40 or more. This represents 124,000 men and 412,700 women or 2500 people for a typical primary care trust population of 200,000. The prevalence of obesity is rising as the average BMI increases. Between 1994 and 1998 the average BMI increased by 0.44 for men and 0.57 for women.

“ NICE recommend that weight loss surgery may be offered if the patient fulfils all the following criteria:

Obesity surgery should be considered only for people who have been receiving intensive management in a specialised hospital obesity clinic .
individuals should be aged 18 years or over.
there should be evidence that all appropriate and available non-surgical measures have been adequately tried but have failed to maintain weight loss.
there should be no specific clinical or psychological contra-indications to this type of surgery.
individuals should be generally fit for anaesthesia and surgery.
individuals should understand the need for long-term follow-up.
Surgery should normally be reserved for those with a BMI of 40 or more but NICE accept that it may be offered to those with a BMI in excess of 35 if they have associated morbidities that may benefit from weight reduction.”

Because of underfunding care for the obese in the NHS, we wonder if there are sufficient resources available to treat EVEN A FRACTION OF THOSE PATIENTS WHO MEET THESE CRITERIA

You and your doctor have agreed: surgery could be the answer to your weight-loss problems.

But what are the disadvantages – and the possible risks – of bariatric surgery? And how will this operation change your life?

Risks of bariatric surgery
Any operation that requires an anaesthetic, which takes between 1 and 3,5 hours to complete, is potentially dangerous.

If one also keeps in mind that patients who undergo these operations are morbidly obese and often suffer from a variety of associated complications such as respiratory disorders, diabetes and heart disease, the risks may be even more.

According to scientific literature, the following risks are associated with bariatric surgery:

a) During or shortly after the operation:

Pulmonary embolism (a blood clot in the lungs), which accounts for up to 70% of deaths that occur during or immediately after surgery
Major wound infections
Peritonitis (inflammation of the membrane of the abdominal cavity)
Narrowing of the entrance to the stomach
Abscesses
Slippage of the gastric band or staples which then require re-operation
b) After surgery

Vomiting
Dysphagia (inability to eat)
Hernia
Heartburn
Diarrhoea
Dumping syndrome (see below)
Malnutrition
Vitamin and mineral deficiencies (see below)
Regain of weight that has been lost
(Msika (2003), Sugermann (2001), Sugermann et al (2003)).

Dumping syndrome
According to Krause (2000), dumping syndrome is “a complex physiological response to larger than normal amounts of food and liquid in the upper parts of the small intestine” due to changes in the rate at which the stomach is emptied.

The symptoms associated with dumping syndrome usually start off with mild effects that include a feeling of fullness and nausea 10 to 20 minutes after eating. Patients may also experience flushing, heart palpitations, fainting, sweating and the urge to sit or lie down.

About one hour after eating, patients may develop abdominal bloating, winds, cramps and abdominal pain and diarrhoea.

Finally, the most extreme stage of dumping syndrome can cause hypoglycaemia (low blood sugar). Patients may perspire, feel anxiety, weakness, shakiness, or hunger, and may be unable to concentrate.

Ironically, the fact that these symptoms can be so severe, can act as a strong motivation to patients to stick to the post-operative dietary rules that they will need to follow for the rest of their lives.

To avoid dumping syndrome, the following guidelines should be applied:

Eat only small meals, which should be spread throughout the entire day (6-8 meals per day).
Eat mainly high-protein, low-fat foods.
Include some dietary fibre if you find that you can tolerate this (e.g. brown bread, oats, brown rice).
Try to rest or lie down one hour after your meals to slow down stomach emptying.
Avoid drinking liquids with your meals, but make sure that you have small quantities of liquid (no more than 100ml), all day long between meals to prevent dehydration.
Avoid cold drinks, juices, pies, cakes, biscuits and frozen desserts or any very sweet foods.
If you find that milk and dairy products don’t agree with you or worsen the symptoms of dumping syndrome, then you may have to avoid them. In such cases, it is essential to take a calcium supplement. Cheese and yoghurt can usually be eaten without discomfort.
Vitamin and mineral deficiencies
Post-operative vitamin and mineral deficiencies are common in patients who have undergone bariatric surgery, namely:

Iron deficiency which can cause anaemia (this is particularly common in female patients who menstruate)
Vitamin B12 deficiency, which can also lead to megaloblastic anaemia
Calcium deficiency, which may cause osteoporosis later in life
Folic acid deficiency
Most bariatric surgery patients need to take vitamin and minerals supplements for the rest of their lives and your surgeon or dietician will advise you which products to use. Regular monitoring of vitamin and mineral levels in the blood is a recommended precautionary measure to pinpoint potential deficiencies.

Advantages of bariatric surgery
The greatest advantage of bariatric surgery is, of course, the significant weight loss that morbidly obese patients achieve. Losses of up to 120kg have been reported.

As these patients lose weight, many of their so-called co-morbidities either disappear or improve dramatically, for example type 2 diabetics may find that they no longer have to take medication and can control their condition with diet alone.

Improvements are also seen in: hypertension, sleep apnoea, obesity hyperventilation syndrome, gastro-oesophageal reflux, venous stasis, urinary incontinence, female sexual hormone dysfunction (e.g. polycystic ovarian disease), degenerative joint disease, and most other obesity-related diseases.

Any patient who has lost a third to half of his/her body weight will naturally be more mobile and active.

In addition, patients experience a great increase in self-esteem, less depression and anxiety, and feel much more self-confident. Patients also find it easier to get jobs and find romantic partners.

Scientists say they may have found out why people get hungry at mealtime, why dieters who lose weight often gain it back and why certain types of stomach surgery help very obese people lose a great deal of weight.
The reason may be a hormone called ghrelin, which makes people hungry, slows metabolism and decreases the body’s ability to burn fat.
Ghrelin Levels
Ghrelin levels in the blood peak before meals and drop afterward. People given ghrelin injections felt voraciously hungry, and, when turned loose at a buffet, ate 30 percent more than they normally would.
Dieters who lose weight and then try to keep it off make more ghrelin than they did before dieting, as if their bodies are fighting to regain the lost fat, researchers are reporting today in the New England Journal of Medicine.
By contrast, the same study showed that very obese people who have an operation called gastric bypass to lose weight wind up with relatively little ghrelin, which may help explain why their appetites decrease markedly after the surgery. Sleeve Gastrectomy operations also remove the section of the stomach in which Ghrelin is produced
Below is an extract from a Scientific paper published in Obesity Surgery, Vol15, 2005
Sleeve Gastrectomy and Gastric Banding: Effects on Plasma Ghrelin Levels
F. B. Langer1; M. A. Reza Hoda1; A. Bohdjalian1; F. X. Felberbauer1;
J. Zacherl1; E.Wenzl1; K. Schindler2; A. Luger2; B. Ludvik2; G. Prager1
1Department of Surgery, Division of General Surgery, and 2Department of Medicine III, Division of
Endocrinology and Metabolism, Medical University Vienna, Vienna, Austria
Ghrelin, recently described as a hunger regulating peptide hormone mainly produced in the fundus of the stomach, is reported to be significantly increased in diet-induced weight-loss. Inconsistent changes in plasma ghrelin levels, however, were reported following different bariatric surgical procedures. Laparoscopic sleeve gastrectomy (LSG), which can be regarded as an advancement of the Magenstrasse and Mill procedure, has been introduced as the first part of a two-step laparoscopic gastric bypass in the “super-super-obese� (i.e. BMI >60 kg/m2) patients in order to reduce the perioperative risk. Furthermore, it has been applied as a definitive bariatric operation in a series of high-risk super-obese patients. Because the gastric fundus, known as the main localization of ghrelin-producing cells, is resected by sleeve gastrectomy, plasma ghrelin levels are expected to decrease following surgery. The aim of this prospective study was to determine the effects of laparoscopic sleeve gastrectomy (LSG) on immediate and 6 months postoperative ghrelin levels, compared with laparoscopic adjustable gastric banding (LAGB).
In this study in 20 morbidly obese patients, we found significantly reduced levels of plasma ghrelin following laparoscopic sleeve gastrectomy immediately after surgery and up to a period of 6 months. In contrast, plasma ghrelin was not changed postoperatively after LAGB and increased significantly after 1 and 6 months. In parallel, excess weight loss was more pronounced following LSG compared with LABG.        To our knowledge this is the first study investigating plasma ghrelin levels in sleeve gastrectomy.                                                                                                                               
Because ghrelin is supposed to be involved in the regulation of appetite, the effects of various bariatric operations on the plasma levels of ghrelin have been a focus of interest in a growing number of recentlypublished papers. While it has been shown that plasma ghrelin increases following diet-induced weight loss18 thereby potentially contributing to weight regain, the data on ghrelin after bariatric operations are inconclusive so far.
In contrast to LAGB, Roux-en-Y gastric bypass was found to decrease the plasma ghrelin level. To explain this discrepancy, it has been speculated that ghrelin-producing cells in the gastric fundus have no further contact with ingested nutrients resulting in an override suppression after RYGBP. In gastric banding patients, however, the ghrelin producing cells are not bypassed. Therefore, these cells remain to function, leading to increased ghrelin levels following LAGB, comparable to diet induced weight loss.                                                                                                          
Sleeve gastrectomy has been established as part of the BPD-DS. Only three studies of sleeve gastrectomy as sole bariatric intervention have been published so far, without focusing on changes of plasma ghrelin levels. In this series of LSG, the greater curvature and the gastric fundus as the main locus of ghrelin production were completely resected, forming a narrow gastric tube that permits oral intake of only small amounts of food. This extensive type of LSG may be understood as a restrictive procedure augmented by the reduction of the ghrelin producing tissue. While the majority of plasma ghrelin originates from the stomach, other locations of ghrelin secretion outside the gastric fundus have been reported. The restrictive effect on food ingestion after LAGB and LSG is comparable. In contrast to Adami, who found ghrelin levels following biliopancreatic diversion comparable to preoperativevalues only 2 months postoperatively, we observed no compensatory hypersecretion of ghrelin as stable low levels were found in the postoperative course up to 6 months following laparoscopic sleeve gastrectomy. This difference could be explained by the extent of gastric resection. In our series the complete fundus was resected, while the fundus was left in situ in the series of Adami
Within 6 months, LSG patients were able to reduce their weight in a more effective way than LAGB patients. In this series, LSG patients presented with higher preoperative plasma ghrelin levels compared with the patients of the LAGB group (109.6 ± 32.6 fmol/ml vs 73.7 ± 24.8 fmol/ml, P=0.005).
Postoperatively, LSG led to significantly decreased and stable plasma ghrelin levels at up to 6 months. In contrast, patients who underwent LAGB presented with significantly increased plasma ghrelin in the postoperative course. Because the restrictive effect regarding food intake is comparable between both methods, the superior effect on weight loss by LSG could be attributed to the permanently lower ghrelin levels preventing an increase in appetite as a compensatory mechanism.
In conclusion, we have demonstrated that in contrast to LAGB, ghrelin levels are significantly decreased following LSG immediately postoperatively, as well as up to 6 months postoperatively in morbidly obese patients. This is paralleled by a superior weight loss after LSG which might be related to the permanent decrease in ghrelin levels preventing a compensatory increase in hunger.