By LYNDSAY MOSS
HEALTH CORRESPONDENT Scotsman
A SURGEON opted to go under the knife himself for an operation that is becoming popular in the fight against obesity.

Chris Oliver lost more than seven stone after the procedure to limit his food intake. And now he is to donate his surgical robes, or “blues”, which he had to have specially made to cope with his 26-stone bulk, to a museum.

He is hoping his story will inspire others who have struggled with serious weight problems to consider the radical operation.

Mr Oliver, 47, a consultant orthopaedic surgeon at Edinburgh Royal Infirmary, decided on the operation – known as bariatric surgery – last year after visiting the Great Wall of China and being unable to walk it.

He had also developed type-2 diabetes linked to his obesity, which increases the risk of heart disease and stroke.

Although Mr Oliver never struggled with his weight early in life, the pressures of work and professional exams saw him pile on ten stone in 20 years.

“Making the choice to have surgery took me a while, and I guess for many people the choice is really hard.

It’s the individual who finally makes the choice,” Mr Oliver said.

After considering the complications, and writing a living will in case something went wrong, he had a gastric band fitted at the Nuffield Hospital, Glasgow, in February. The band is a belt that is tightened around the stomach, reducing the amount of food that can be consumed.

Mr Oliver has since lost almost 100lb, taking him to 19st, and is hoping to shed a further 4st by Christmas. The father of two teenage daughters has also been taking regular exercise, including cycling. “I’ve had to cut links out of my watch strap and all my shoes are too big,” he said.

Mr Oliver has just handed over his surgical blues for public display. “I can now fit into normal surgical wear, so I donated them to the Royal College of Surgeons Museum – a bit of bariatric social surgical history,” he said.

The operation came to prominence when the former television presenter Anne Diamond admitted last year that she had had a similar procedure.

Choosing to pay for gastric band surgery – which costs between £7,500 and £8,000 – means patients can avoid long NHS waiting lists. But surgeons will still carry out the operation only as a last resort.

David Galloway, a consultant bariatric surgeon in Glasgow, said he had performed up to 500 gastric-band operations in the past seven years – 200 of these in the past year alone.

“My strong impression is that this type of surgery is increasing,” he said. “It can be difficult to access this surgery on the NHS, which rightly tries every other option for patients.”

Mr Galloway said weight-control surgery was not a “magic bullet” and was not the only option for patients. But he added:

“For the right patients, surgery can be a passport to a happier and more fulfilled life.”

Shona Robison, the public health minister, said: “Surgery for obesity is rare and should only be used when all appropriate and available non-surgical measures have failed.”

Centres for obesity surgery are run in Glasgow and Aberdeen, with plans for a further one in Dundee or Edinburgh.

THE PLASTIC BAND THAT STOPS YOU EATING
GASTRIC banding is the most commonly used weight-control surgery in the UK.

The plastic band acts like a belt, positioned around the top portion of the stomach.

This reduces the space in the stomach so patients feel full after eating only a small quantity of food – around three small meals a day.

• A more major procedure is a gastric bypass operation. This works by making the stomach smaller and removing part of the bowel to make the digestive system shorter. It means patients can only eat small meals and their body will take up fewer calories from what they eat.

• Any kind of weight-control surgery is a major procedure, with a small risk of complications. Doctors also warn surgery will not be successful unless patients exercise and eat properly.

• The risk of complications means some patients opt for quicker fixes such as liposuction. But the fat can easily return unless a healthy diet is followed.

• Doctors can also prescribe certain weight-control drugs.

Scotsman 5 Nov 2007
LEADING surgeon Chris Oliver, who has had gastric band surgery, says he is “delighted” at being re-elected on to the council for the Royal College of Surgeons.

The consultant trauma orthopaedic surgeon at Edinburgh Royal Infirmary had the “life-changing” operation after tipping the scales at 26 stone.

Dr Oliver, 47, said: “I am delighted I have been re-elected to RCSEd Council for five years. Congratulations also to Judy Evans who got the other place.

“It has been an amazing year for me. My life has changed completely since my lap band surgery as I have now lost 100 pounds in weight. My new-found fitness and energy will allow me to return to my previous sporting activities.”

The Border Mail – Australia 30 August 2007
SEVERELY obese Australians should have access to cheap lap-band surgery to lengthen life and reduce the weight burden on the health system, obesity experts say.

Specialists are urging the Federal Government to make Medicare rebates available for the controversial stomach surgery, after international studies confirmed it could cut death rates.

Research from the US and Sweden released this week showed obese people who underwent the procedure had a mortality rate up to 40 per cent lower than their bandless counterparts.

Public health specialists say mounting evidence supports making lap-band surgery more widely and cheaply available for Australians with an extreme weight problem.

Access in the public health system is very limited.

Almost all of the 8000 people who get the adjustable band fitted each year pay up to $10,000 to have it done privately.

Professor John Dixon, from the Centre for Obesity Research at Monash University in Melbourne, said it was time to act now to make lap-band surgery publicly funded and widely available.

While it was expensive, the surgery had been proven beyond a doubt to be cost-effective, he said.

“It extends life, improves quality of life and severely limits the risk of developing diabetes, heart problems and other disease, but we have been slow to act on that knowledge,� he said.

Professor Dixon said about 8 per cent of adult Australians were obese, with a body mass index over 35, making them eligible for lap-band surgery.

“We’ve got to be realistic. That is what health is about,� he said.

Banbury Guardian 29 August 2007

A MOTHER who is sporting a whole new look after undergoing major plastic surgery will be baring all on national television.

Salena Newport, 40, of Adderbury is appearing on Channel 4 makeover programme 10 Years Younger on Thursday, August 30, where viewers will see the results of her extensive operations.

Mrs Newport – who used to weigh 231/2 stone and wore size 32 clothes – lost 121/2 stone in 2005 after paying £5,000 to have a gastric band fitted.

But the dramatic weight loss left her with baggy, excess skin.
As part of the popular TV show, which aims to make participants look ten years younger, Mrs Newport had loose skin cut from her arms and thighs, a complete lower body lift, breast uplift and implants, a nose job and new teeth.

History
The Vertical Sleeve Gastrectomy procedure (also called Vertical Gastrectomy, Sleeve Gastrectomy, Greater Curvature Gastrectomy, Parietal Gastrectomy, Gastric Reduction, Logitudinal Gastrectomy and even Vertical Gastroplasty) is performed by approximately 20 surgeons worldwide.  This forum is titled “VSG forum� to include the two most common terms for the procedure(vertical and sleeve).   The earliest forms of this procedure were conceived of by Dr. Jamieson in Australia(Long Vertical Gastroplasty, Obesity Surgery 1993)- and  by Dr. Johnston in England in 1996 (Magenstrasse and Mill operation- Obesity Surgery 2003).  Dr Gagner in New York, refined the operation to include gastrectomy(removal of stomach) and offered it to high risk patients in 2001.  Several surgeons worldwide have adopted the procedure and have offered it to low BMI and low risk patients as an alternative to laparoscopic banding of the stomach.

It generates weight loss by restricting the amount of food (and therefore calories) that can be eaten by removing 85% or more of the stomach without bypassing the intestines or causing any gastrointestinal malabsorption.  It is a purely restrictive operation.  It is currently indicated as an alternative to the Lap-Band® procedure for low weight individuals and as a safe option for higher weight individuals.

full article http://www.obesityhelp.com/forums/vsg/cmsID,8874/mode,content/a,cms/

Studies of stomach-surgery patients offer the strongest evidence yet that shedding pounds can extend life.
Obese people are significantly less likely to die if they undergo stomach surgery to lose weight, according to two new studies that offer the first convincing evidence that the health gains of losing weight translate into living longer.
The research, involving 20,000 obese people in the United States and Sweden, found that those who underwent surgery had a 30 percent to 40 percent lower risk of dying over the next seven to 10 years compared with those who went without the operations.
Previous research has shown that losing weight cuts the risk of diabetes, heart disease, cancer, and other major ailments and suggested that might lead to an increase in longevity. But the new studies offer the strongest evidence to date in answer to one of the most important and contentious questions about one of the western world’s biggest health problems: Does weight loss result in not only healthier lives but also longer ones?
“The question as to whether intentional weight loss improves life span has been answered,” wrote George Bray of the Pennington Biomedical Research Center in Baton Rouge, La., in a commentary accompanying the reports in today’s New England Journal of Medicine.
“The answer appears to be a resounding yes.”

“Morbid obesity is a disease. Bariatric surgery is the only efficient treatment of morbid obesity. It is a matter of life and death. The results of this major scientific study will, I hope, contribute to eliminate the preconceived ideas against morbidly obese persons and bariatric surgery”, says Jennifer Schultz, cofounder of the Coalition against Morbid Obesity . “This study effectively shows the beneficial impact of bariatric surgery on the health and survival of morbidly obese people.”
Morbid obesity is the starting point for different types of diseases that are often fatal, such as arterial hypertension, Type 2 diabetes, or heart disease. An individual’s obesity level can be evaluated by means of the body mass index (BMI), which is calculated by dividing the person’s weight by his or her height squared (Kg/m(2)). Morbid obesity corresponds to a BMI higher than or equal to 40, or higher than or equal to 35 if accompanied by comorbidities.
According to the World Health Organization (WHO), bariatric surgery is considered to be the only effective treatment for morbid obesity. Bariatric surgery includes a series of techniques that are based on two intervention principles: Restriction and Malabsorbtion. Restrictive procedures include Gastric Banding (the lap band) and the relatively new technique of Vertical Sleeve Gastrectomy, which is producing some very encouraging results. Malabsorptive procedures include Gastric Bypass and Duodenal Switch.

BBC NEWS Scotland 17/07/08

A woman who weighs 24 stone intends to take Greater Glasgow and Clyde Health Board to court if it does not consider her for weight-loss surgery.
Laura Brown, 34, insists her weight is leaving her in pain and house-bound.  She became angry after the health authority told her she would have to attend a year-long diet programme before she could undergo surgery.

Ms Brown, from Glasgow, believes her only option to lose weight is to have a gastric band fitted around her stomach.

Seven years ago she lost 12 stone with the help of weight loss drugs prescribed by her doctor. Since then she has put all the weight back on.

The health board have told Ms Brown that she will have to attend their weight management programme for at least a year before she can be put forward for the operation.

In England it is recommended that anyone with a BMI of over 40, like Ms Brown, should automatically be considered for surgery because of the cost efficiency. Scottish guidelines are currently under review.
 

By Angela Parker Indystar.com 15/08/07
If you’re thinking those laugh lines aren’t so funny anymore or that surgery might be the only way to shed dangerous extra pounds, here’s a tip: Having realistic expectations and determination are requirements for successful cosmetic or bariatric surgery.
 
For cosmetic surgery patients, realistic expectations are like best friends who tell the truth even when it hurts. Expecting surgery to turn a Phyllis Diller into a Julia Roberts is just not realistic — but expecting to look like a younger version of yourself is totally achievable. Dr. Catherine P. Winslow, FACS, Winslow Facial Plastic Surgery, recommends looking at photographs from 10 years ago to get an idea of what surgery can accomplish.

“Anti-aging surgery is designed to take the years off, not alter the way you look,� Winslow said. “If patients have good expectations, they are going to be pleased with the results. If they have inappropriate expectations, they are going to be unhappy no matter what you do.�

Extensive presurgery counseling with a surgeon or psychologist helps ensure patients have the proper perspective, and it can reveal unhealthy attitudes that would make them poor surgery candidates.

After surgery, patients might experience mild depression early in the healing process. Though they know to expect some swelling, seeing their faces in that condition can be disconcerting.

“A lot of hand-holding is involved in getting patients to the point where they are happy with the results,� Winslow said.

For bariatric surgery patients, determination is the critical element. It’s a mistake to think surgery alone is a cure for obesity. After the initial dramatic weight loss, patients must be determined to keep the pounds off for a lifetime.

“We can deliver a lot of skill and advice and performance. But if the recipient is not going to be a team player, then no matter how good our work is, it’s not going to work out,� said Dr. Samer G. Mattar, medical director, Clarian Bariatric Center.

Ironically, patients must start losing weight six months before surgery. Bariatric surgery risks are about the same as with gall bladder surgery, but obese patients can reduce their risk by changing their diets and shrinking their enlarged livers. This enables the surgeon to maneuver more easily behind it to work on the stomach.

Patients who are unwilling to make this effort likely won’t have the determination to make their surgery a lifelong success.

“The only patient who is not suitable is the patient who is not willing to see me in preparation for surgery,� said Ruthanne M. Hilbrich, RD, nutrition coordinator, Clarian Bariatric Center. “They have to shrink that liver, and if they are not willing to, I postpone their surgery.�

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 Carolyn Johnson – ABC7 San Francisco
Is This A New Weight Loss Solution?
In May we followed a patient through a relatively new stomach reduction procedure, a Gastric Sleeve, and the patient was told to expect dramatic changes within the first three months. We wanted to see if the promises held true, so we went along for his three months checkup. Gregg Jossart, M.D., California Pacific Medical Center: “He’s a tall man, so he’ll probably lose about 70 to 80 pounds in the first ninety days, and his diabetes will probably be cured two to three months from now, and his blood pressure should be dramatically improved and that should be cured as well.”                                                                                                                                                          Bold predictions from Dr. Gregg Jossart, chief of minimally invasive surgery at California Pacific Medical Center.                                           Patient Scott Coffelt weighed in at 340 pounds the day of surgery. With small incisions, similar to those used for gastric banding or the “lap band”, doctors separated Scott’s stomach from the surrounding tissue and stapled off the majority of it, leaving just a tiny pouch. The rest of his stomach, removed for good along with the part that produces the hormone ghrelin, believed responsible for stimulating appetite. Unlike a gastric bypass, the intestines were not re-routed.                                                                                                                                                                Dr. Jossart: “You’ve lost 65 pounds in about 90 days.”                                                                                                                                       And with that weight loss came great gains.                                                                                                                                                          Scott Coffelt, stomach reduction patient: “I haven’t taken any medication since the day after surgery. Nothing for diabetes, high blood pressure, cholesterol, any of that. all the pills are gone.”

More http://abclocal.go.com/kgo/story?section=edell&id=5556228