Pre-operative assessment and preparation
All patients must be carefully assessed to check that surgery is the correct treatment for them and that they are fit enough for the procedure. They meet or speak to some or all of the following: the patient coordinator, dietitians, psychologists, anaesthetists, surgeons. A key to good results and few problems is careful follow-up, which should be arranged by the team looking after you.
The patient coordinator
Your patient coordinator will manage your visits with other members of the team. They will put all of your information together for the other specialists to discuss at regular meetings. This allows the best decisions to be made about your care. If you have any problems or questions you can call the coordinator at any time.
Your dietitian will often be the first person that you meet. They will ask you questions about the problems you are having, how they developed and how you eat to help decide your best management. They will check your height and weight. If you go ahead to surgery they will give you advice about diets that make the surgery safer. After the surgery they will advise you on your best diet for success, check your weight and give you advise about supplements.
Your psychologist will meet you before your surgery. They will ask questions about aspects of your life that affect your eating behaviour and to check that the changes surgery makes to your eating will not cause you undue distress. They will also help advise you on how to prepare yourself psychologically for the changes that you are about to go through.
Your anaesthetist will meet or speak to you before the surgery to check that you have no health problems that will cause you any difficulty under anaesthetic. They will often meet you after a “pre-assessment” clinic with one of BMI Healthcare’s nurses to check routine observations like your blood pressure. They will help to sedate you or put you to sleep for your procedure.
Your surgeon will usually meet you with or after the dietitian. Some patients are referred directly to him by their GPs. He will ask you questions about the problems your weight is causing you, what your eating behaviour is like and what weight-loss techniques you have tried. This will help him advise you on your best treatment. He can discuss surgery in general and different procedures with you at the consultation. Together you will choose the best treatment for your problems. He will perform your surgery and look after you in hospital. He will also follow you up after the surgery and you will easily be able to contact him.
Weight-loss surgery provides a tool to help people regain control of their weight. To get the most out of the surgery they need to be well prepared. All the operations have best outcomes when patients learn to pay attention to their eating habits and to make healthy lifestyle and activity changes. There is a limit to the amount of weight lost and most patients will lose somewhere between 20 and 33% (1/5 to 1/3) of their overall weight by about 2 years. So, most patients are still overweight after the end of the programme. However, this should be a much healthier weight. However well someone does with bariatric surgery, for however long, if the surgery is undone, then they are likely to regain weight. Therefore, the operations should all be done with the thought that they are to be permanent.
There are risks for all the operations. However, patients who are severely overweight also have risks to their health; many of which can be decreased by surgery.