Who should get gastric banding?

Sash · 03-06-2008, 13:40

Television presenter Fern Britton has caused controversy after it was revealed that her recent weight loss followed a "gastric band" operation, and was not simply down to dieting and exercise.

But how does a gastric band work, who should receive them, and is there still a stigma attached?

For some obese people, attempts at conventional dieting and exercise will fail, and their weight means a far higher risk of health problems later in life.

It is at this point that their doctor may suggest gastric banding.

The principle is a simple one. Most people eat when they feel hungry, and when their stomachs are full, they stop.

The operation leaves a silicone loop tightened about three-quarters of the way up the stomach, creating a much smaller space at the top, with a tiny gap leading to the rest of the stomach.

Much less food is needed to fill up this little "pouch" at the top, at which point the person feels full.

The "pouch" then slowly empties through the gap into the rest of the stomach, and appetite returns.

Dr Ian Campbell, Medical Director of the charity Weight Concern, said: "If you reduce the volume of food you can comfortably put in your stomach, you'll eat less."

The NHS does offer gastric banding, but many people choose to have the operation privately, at a cost of around £7,000.

On average, people will lose up to 50% of their excess weight in the two years after they have one, almost immediately cutting the risk of diabetes, heart disease or high blood pressure.

But it is not recommended to all obese people - guidelines from the National Institute of Clinical Excellence say that it should be considered only after other, non-surgical solutions, have been fully exhausted, and patients need to be free of psychological problems, and receive the correct advice and counselling.

New lifestyle

The reason it is not recommended to all overweight people are the small, but significant risks of having a band, which are normally balanced against the health risks of obesity.

BBC Breakfast discussion on the issue of gastric bands

Although the band is normally placed using "keyhole" surgery, having a general anaesthetic still carries a risk, especially to an obese patient. There is also the chance of infection, or a problem with the band, such as leakage, which will require a second operation to correct.

Dr Campbell insists it is no easy option. Patients will need to change what they eat - the new stomach shape may not cope well with food which comes in large chunks, causing vomiting, and lavish dinner parties may be a thing of the past.

"You need to break off your love affair with food. You simply can't sit down to a three course meal with your friends any more."

Despite that, the stigma remains, despite the fact that thousands of gastric banding operations are carried out each year in the UK.

Fern Britton chose to keep her operation private, and was criticised for doing so by newspaper columnist Carole Malone.

"She is a public persona, but she is making money out of her weight. She also has made a career out of being a trustworthy person - a person that people look up to.

"She shares lots of parts of her life with the viewing public, and she gets paid an awful lot of money for that. She has made a little bit of a career out of dieting."

Psychological need

Some psychologists are also not convinced that the rising numbers of operations is a good thing.

Dr Funke Baffour, who specialises in the psychology of weight management, suggested that would-be patients should first be dealing with the underlying emotional issues which helped cause the weight gain.

"People aren't using their willpower, they're looking for a quick fix, but this will not resolve the psychological problems they may have.

"I'm of the opinion that no-one should need that drastic an intervention.

"I have had patients who are thinking about it, tell me they have done everything they can to lose weight, but, after discussing it, they haven't."

Dr Campbell, however, is adamant that the public perception of weight loss surgery is a false one. He said: "It's seen as a cop-out, a cowardly way of dealing with it.

"But what we have here is a perfect example, someone who is an intelligent, very able person, who has tried everything, over many years, without success.

"The forces that make her overweight cannot be overcome just by willpower."

BBC NEWS | Health | Who should get gastric banding?

Paparika · 06-06-2008, 16:29

Not every obese person is fat because they eat too much.

Some illness / medication will put the weight on whether you like it or not, this is when i think people should have the option if it is safe for them to do so.

emma roids · 06-06-2008, 18:28

wassup wi been a porker like??

if you wanna lose weight and cant do it the conventional way and can afford a gastric band then go for it

draganess · 06-06-2008, 20:02

I asked my doc about having one but she said no straight away lol apparently Im not fat enough to have it done on the nhs and I definitely wouldn't pay to go private.

Puratech · 06-06-2008, 20:14

Ask them how fat you need to be and spend the next 6 months pigging out until you qualify

Seriously though, unless the nhs can justify it being cheaper to do the op than to deal with long term problems i dont really agree with it.

Aside from those who are fat because of rare disorders, prescription drugs, ie. those of us who thinks a 6 pack is something you drink each evening

should just deal with it themselves. Its amazing that theres a huge market for diet books, tv shows, bizarre exercise devices and exercise videos, when all most people need to do is choose to stop eating more food than necessary.

Its funny how addiction and lifestylewise its so similar to smoking, yet smokers are looked at and treated with contempt, but fat people have fat rights. With the exception to those who are the weight of 4 people, you dont see shops charging more for bigger clothes because of material or taxis charging you more because of the worsened fuel consumption

draganess · 06-06-2008, 22:46

I asked more out of curiousaty really. We where discussing things I could do that would help weight loss that wouldn't make my back worse, as I had to stop going to the gym cos I over did it a bit and made things worse.

There is the other side of things, as private will do it for women that are not very over weight. There was the case of the lady in Hull I think it was, that died from toxemia and she was only 14stone. When you go private are the rules for the op different? This woman couldn't get the opp on the NHS, for good reasons?

Eraserhead · 07-06-2008, 00:04

I would have thought if you're weight is not causing you serious secondary health problems the risks involved with surgery are likely to result in you not qualifying. Such cases could be considered cosmetic and not so high on the NHS list of priorities.

Tagred · 07-06-2008, 00:35

I found out today that my sister was diagnosed with a thyroid problem somehow related to her polycystic ovaries. the consultant said that if the drugs dont work she would need radiotherapy or a hystarectamy. She used to be a slim girl and shapely, she was stunning. Unfortunately because of her problems she put on a lot of weight, and even though she runs regularly and has been on a strict diet for a long time it hasnt had much effect.

It's one of those things that really pisses me off when people say that it is only related to the amount of calories consumed that make people fat. My sis again has to go through operations to sort her out and even though she said she wouldnt mind a hysertoctamy (sp) she still needs treatment on her thyroid to keep her healthy. It means that she may never have any more kids, shes got 3 and dont want any more but the point is that even though she isnt obese, people automitcally attach a stigma.

In my case its because i ate food when i stopped doing the excercise i used to do. It isnt that simple, theres a lot of pyschology in it, and people who dont get it don't have a clue. Just like stress, everyone has their own tolerance level.

Try telling an anorexic to stop throwing up even though they know they are killing themselves, and I gurantee you wont succeed. Proper root cause anaylsis is needed and only the ignorant come up with black & white solutions. If it was that easy no-one would be obese.

Mankind · 08-06-2008, 20:17

All gastric banding does is reduce the amount of food you can physically eat in one sitting, you could do this without the band, it would be unpleasant, but that's what dieting is, it's not fun and there is no shortcut, low-cal food tastes like shit and being hungry sucks, you just have to bear it.

I went from a 28 inch waist to a 36 inch one through eating like a pig, I have not been obese but was on my way lol

. Slimmed back down eating < 1000 kcals a day as opposed to my usual 3-4000, helped by Marlboro Lights and a slight raise in metabolism by cheap thermogenic drugs. It was boring and tedious but it did the job. Of course I was just a run-of-the-mill fatty and had no medical reason, I'm sure it's even harder for people with genuine problems, but you can't cheat physics, you need calories in > calories out to put on weight.

I have no problem with the NHS giving people gastric banding, there is more than enough tax money to pay for it, like the £100m to be spent on new buildings with wine cellars and art galleries for the house of lords.

teflon · 09-06-2008, 02:06

I agree with most of that, if fat people all got made skinny, then more work would get done and Britain would be better at sports.

llll · 09-06-2008, 17:43

Quote:

Originally Posted by Mankind

All gastric banding does is reduce the amount of food you can physically eat in one sitting, you could do this without the band, it would be unpleasant, but that's what dieting is, it's not fun and there is no shortcut, low-cal food tastes like shit and being hungry sucks, you just have to bear it.

I went from a 28 inch waist to a 36 inch one through eating like a pig, I have not been obese but was on my way lol

. Slimmed back down eating < 1000 kcals a day as opposed to my usual 3-4000, helped by Marlboro Lights and a slight raise in metabolism by cheap thermogenic drugs. It was boring and tedious but it did the job. Of course I was just a run-of-the-mill fatty and had no medical reason, I'm sure it's even harder for people with genuine problems, but you can't cheat physics, you need calories in > calories out to put on weight.

I have no problem with the NHS giving people gastric banding, there is more than enough tax money to pay for it, like the £100m to be spent on new buildings with wine cellars and art galleries for the house of lords.

I ate 2 whole boxes of frosties in about an hour when i tried to stop smoking..it's weird how smoking supresses your appetite..I think if i didnt smoke id be really badly fat now ><
grats on losing all that weight ;D
I dont get why ppl didnt like fern having the gastric thing done..why is it anyones business other than hers? ;o
I think anyone should be able to have it done if they want..If they dont have enough willpower to manage eating less , they would still have to exercise or they would end up with loads of excess skin, wouldnt they?
Its hard losing weight,it's probably quite a lot harder if you have to for health reasons too rather than wanting to look better.I would imagine it would be really stressful and they should be helped as much as posssible...and they should give me their chocolatess as they

03-06-2008, 13:40	#1 (permalink)
Name & Title Sash BiteMe Avatar Mood Karma Pu7,556.26 Critters My Critters	Who should get gastric banding? Television presenter Fern Britton has caused controversy after it was revealed that her recent weight loss followed a "gastric band" operation, and was not simply down to dieting and exercise. But how does a gastric band work, who should receive them, and is there still a stigma attached? For some obese people, attempts at conventional dieting and exercise will fail, and their weight means a far higher risk of health problems later in life. It is at this point that their doctor may suggest gastric banding. The principle is a simple one. Most people eat when they feel hungry, and when their stomachs are full, they stop. The operation leaves a silicone loop tightened about three-quarters of the way up the stomach, creating a much smaller space at the top, with a tiny gap leading to the rest of the stomach. Much less food is needed to fill up this little "pouch" at the top, at which point the person feels full. The "pouch" then slowly empties through the gap into the rest of the stomach, and appetite returns. Dr Ian Campbell, Medical Director of the charity Weight Concern, said: "If you reduce the volume of food you can comfortably put in your stomach, you'll eat less." The NHS does offer gastric banding, but many people choose to have the operation privately, at a cost of around £7,000. On average, people will lose up to 50% of their excess weight in the two years after they have one, almost immediately cutting the risk of diabetes, heart disease or high blood pressure. But it is not recommended to all obese people - guidelines from the National Institute of Clinical Excellence say that it should be considered only after other, non-surgical solutions, have been fully exhausted, and patients need to be free of psychological problems, and receive the correct advice and counselling. New lifestyle The reason it is not recommended to all overweight people are the small, but significant risks of having a band, which are normally balanced against the health risks of obesity. BBC Breakfast discussion on the issue of gastric bands Although the band is normally placed using "keyhole" surgery, having a general anaesthetic still carries a risk, especially to an obese patient. There is also the chance of infection, or a problem with the band, such as leakage, which will require a second operation to correct. Dr Campbell insists it is no easy option. Patients will need to change what they eat - the new stomach shape may not cope well with food which comes in large chunks, causing vomiting, and lavish dinner parties may be a thing of the past. "You need to break off your love affair with food. You simply can't sit down to a three course meal with your friends any more." Despite that, the stigma remains, despite the fact that thousands of gastric banding operations are carried out each year in the UK. Fern Britton chose to keep her operation private, and was criticised for doing so by newspaper columnist Carole Malone. "She is a public persona, but she is making money out of her weight. She also has made a career out of being a trustworthy person - a person that people look up to. "She shares lots of parts of her life with the viewing public, and she gets paid an awful lot of money for that. She has made a little bit of a career out of dieting." Psychological need Some psychologists are also not convinced that the rising numbers of operations is a good thing. Dr Funke Baffour, who specialises in the psychology of weight management, suggested that would-be patients should first be dealing with the underlying emotional issues which helped cause the weight gain. "People aren't using their willpower, they're looking for a quick fix, but this will not resolve the psychological problems they may have. "I'm of the opinion that no-one should need that drastic an intervention. "I have had patients who are thinking about it, tell me they have done everything they can to lose weight, but, after discussing it, they haven't." Dr Campbell, however, is adamant that the public perception of weight loss surgery is a false one. He said: "It's seen as a cop-out, a cowardly way of dealing with it. "But what we have here is a perfect example, someone who is an intelligent, very able person, who has tried everything, over many years, without success. "The forces that make her overweight cannot be overcome just by willpower." BBC NEWS \| Health \| Who should get gastric banding?
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06-06-2008, 16:29	#2 (permalink)
Name & Title Paparika Anti-Chav Avatar Mood Karma Pu11,776.18	Not every obese person is fat because they eat too much. Some illness / medication will put the weight on whether you like it or not, this is when i think people should have the option if it is safe for them to do so.
	Paparika's Sig: TEENAGERS Fed up with stupid parents? Act quickly! Move out, get a job, pay your own bills, while you still know everything!
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06-06-2008, 18:28	#3 (permalink)
Name & Title emma roids dab some cream on. Avatar Mood Karma Pu21,366.82	wassup wi been a porker like?? if you wanna lose weight and cant do it the conventional way and can afford a gastric band then go for it
	emma roids's Sig:click this link, build my city. thanks When we grew up and went to school There were certain teachers who would Hurt the children in any way they could By pouring their derision Upon anything we did And exposing every weakness However carefully hidden by the kids But in the town, it was well known When they got home at night, their fat and Psychopathic wives would thrash them Within inches of their lives. awww bless em oblivion imperial tower jump
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06-06-2008, 20:02	#4 (permalink)
Name & Title draganess Supervisor Avatar Mood Karma Pu9,798.95	I asked my doc about having one but she said no straight away lol apparently Im not fat enough to have it done on the nhs and I definitely wouldn't pay to go private.
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06-06-2008, 20:14	#5 (permalink)
Name & Title Puratech nybegynder Avatar Mood Karma Pu13,872.38	Ask them how fat you need to be and spend the next 6 months pigging out until you qualify Seriously though, unless the nhs can justify it being cheaper to do the op than to deal with long term problems i dont really agree with it. Aside from those who are fat because of rare disorders, prescription drugs, ie. those of us who thinks a 6 pack is something you drink each evening should just deal with it themselves. Its amazing that theres a huge market for diet books, tv shows, bizarre exercise devices and exercise videos, when all most people need to do is choose to stop eating more food than necessary. Its funny how addiction and lifestylewise its so similar to smoking, yet smokers are looked at and treated with contempt, but fat people have fat rights. With the exception to those who are the weight of 4 people, you dont see shops charging more for bigger clothes because of material or taxis charging you more because of the worsened fuel consumption
	Puratech's Sig:The present's just a pleasant interuption to the past... Quocunque Jeceris Stabit
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06-06-2008, 22:46	#6 (permalink)
Name & Title draganess Supervisor Avatar Mood Karma Pu9,798.95	I asked more out of curiousaty really. We where discussing things I could do that would help weight loss that wouldn't make my back worse, as I had to stop going to the gym cos I over did it a bit and made things worse. There is the other side of things, as private will do it for women that are not very over weight. There was the case of the lady in Hull I think it was, that died from toxemia and she was only 14stone. When you go private are the rules for the op different? This woman couldn't get the opp on the NHS, for good reasons?
	draganess's Sig: Mir3Stock pics
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07-06-2008, 00:04	#7 (permalink)
Name & Title Eraserhead ... Avatar Karma Pu5,886.65	I would have thought if you're weight is not causing you serious secondary health problems the risks involved with surgery are likely to result in you not qualifying. Such cases could be considered cosmetic and not so high on the NHS list of priorities.
Name & Title Eraserhead ... Avatar Karma Pu5,886.65
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07-06-2008, 00:35	#8 (permalink)
Name & Title Tagred Sometime Helper :P Avatar Mood Karma Pu14,435.49	I found out today that my sister was diagnosed with a thyroid problem somehow related to her polycystic ovaries. the consultant said that if the drugs dont work she would need radiotherapy or a hystarectamy. She used to be a slim girl and shapely, she was stunning. Unfortunately because of her problems she put on a lot of weight, and even though she runs regularly and has been on a strict diet for a long time it hasnt had much effect. It's one of those things that really pisses me off when people say that it is only related to the amount of calories consumed that make people fat. My sis again has to go through operations to sort her out and even though she said she wouldnt mind a hysertoctamy (sp) she still needs treatment on her thyroid to keep her healthy. It means that she may never have any more kids, shes got 3 and dont want any more but the point is that even though she isnt obese, people automitcally attach a stigma. In my case its because i ate food when i stopped doing the excercise i used to do. It isnt that simple, theres a lot of pyschology in it, and people who dont get it don't have a clue. Just like stress, everyone has their own tolerance level. Try telling an anorexic to stop throwing up even though they know they are killing themselves, and I gurantee you wont succeed. Proper root cause anaylsis is needed and only the ignorant come up with black & white solutions. If it was that easy no-one would be obese.
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08-06-2008, 20:17	#9 (permalink)
Name & Title Mankind Full Member Mood Karma Pu17,073.02	All gastric banding does is reduce the amount of food you can physically eat in one sitting, you could do this without the band, it would be unpleasant, but that's what dieting is, it's not fun and there is no shortcut, low-cal food tastes like shit and being hungry sucks, you just have to bear it. I went from a 28 inch waist to a 36 inch one through eating like a pig, I have not been obese but was on my way lol . Slimmed back down eating < 1000 kcals a day as opposed to my usual 3-4000, helped by Marlboro Lights and a slight raise in metabolism by cheap thermogenic drugs. It was boring and tedious but it did the job. Of course I was just a run-of-the-mill fatty and had no medical reason, I'm sure it's even harder for people with genuine problems, but you can't cheat physics, you need calories in > calories out to put on weight. I have no problem with the NHS giving people gastric banding, there is more than enough tax money to pay for it, like the £100m to be spent on new buildings with wine cellars and art galleries for the house of lords.
Name & Title Mankind Full Member Mood Karma Pu17,073.02
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09-06-2008, 02:06	#10 (permalink)
Name & Title teflon what Avatar Karma Pu24,096.01	I agree with most of that, if fat people all got made skinny, then more work would get done and Britain would be better at sports.
Name & Title teflon what Avatar Karma Pu24,096.01
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