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Operation that could take the weight off the NHS by tackling obesity early !

Kevin1708

New Member
Yorkshire Evening Post

Published on Wednesday 23 March 2011 20:37

http://www.yorkshirepost.co.uk/news/features/operation_that_could_take_the_weight_off_the_nhs_by_tackling_obesity_early_1_3204605

With new obesity surgery being pioneered in Leeds, Sarah Freeman goes into theatre and meets one of the first patients to put the procedure to the test.

Andrea Shires is 45 years old. While drawing the line at the grapefruit diet, she has tried every other weight loss programme going. At her heaviest she weighed 16 stone and, while the scales fluctuate, last year she thought she’d finally cracked it.

After 10 months on the Lighter Life programme – an updated version of the old Cambridge Diet – she dropped seven stone and a handful of dress sizes. Surviving on the shakes, bars and soups was not easy and when she gradually began to reintroduce food, the weight started to pile back on. Within weeks, the mother-of-three was back to square one.

“My weight has yo-yoed since I was about 10 and I have spent most of my adult life on diets. Last year, I honestly thought I’d beaten it. I spent April to the following February drinking the shakes, I got through Christmas without any problem and I promised myself I was never going to go back to being overweight. But I did and I was at a loss to know what to do.”

When we meet, Andrea is in a private room of the Nuffield Health Hospital Leeds. In a couple of hours she will undergo surgery which she hopes will be the answer to her prayers of the last 35 years.

She is overweight, but bears little resemblance to the images of the morbidly obese which accompany each new report of the nation’s growing waistline. Despite a lifelong battle with her weight, according to guidelines she doesn’t tip the scales enough to qualify for help on the NHS.

“To be eligible I would have to eat to make myself even fatter. It’s not something I have any intention of doing. Also I have read a lot about procedures like gastric bands and bypasses and I don’t really feel comfortable about either, particularly about the bands which often have to be replaced. I guess I had resigned myself to being a full-time dieter.”

The possibility there may be one last option came when she read an article about a brand new type of weight loss surgery in a local newspaper. Nuffield surgeons are among the first in Europe to offer the procedure, which unlike most obesity surgery requires no incision, has a quicker recovery rate – if all goes well Andrea will be back at home by the evening – and leaves no visible scars.

Primary Obesity Surgery, Endolumenal, known as POSE, has been pioneered to help those struggling to control their weight but whose Body Mass Index hasn’t yet reached 50 – the point at which NHS surgery becomes available.

It’s early days. Andrea will only be the seventh person to undergo the procedure in Leeds and across the country, cases total around 25. However, the initial results of the surgery, which involves reducing the size of the stomach using specialist instruments inserted via the mouth, appear positive.

While Andrea is being prepared for the operation, which should last a little over an hour, surgeons James Halstead and Professor Michael McMahon grab a quick coffee in the staff room.

“There is an underlying misconception, not just in this country, that people can control their weight,” says Prof McMahon.

“They can’t and until we understand that we are never going to solve the problem of obesity.

“People diet, some are successful, but the vast majority struggle to maintain long-term results and a significant number will become morbidly obese and develop a myriad of health problems.”

The POSE surgery costs in the region of £6,000, a large outlay for an individual, but a fraction of what the NHS could spend on dealing with the consequences of obesity.

“If you calculate the amount of money spent by the NHS on dealing with people who have developed diabetes, heart problems and everything else which comes with being obese, it would seem to make sense to look at ways of tackling the issue before it gets to that critical stage,” says Prof McMahon. “I have no doubt it would save money in the long-term, but sadly it’s not something which seems to be on the NHS’ agenda.” A nurse signals that Andrea, who will be under general anaesthetic, is ready and the surgeons move into the theatre.

The equipment, cased in a thick tube is fed through her mouth to the stomach area, a small camera showing the image of her insides on half a dozen monitors. Small sections of stomach tissue are grabbed and once both surgeons are happy, it is fixed in place using special sutures. It looks not unlike a medical version of the claw machines you get in amusement arcades.

It takes a little while to get the instruments in the correct position, but once the first fold is completed, the medical team are in their stride. Aside from the regularly bleeping of the machines monitoring Andrea’s heart rate and the occasional compliment handed round for a particularly good tissue grab, the theatre works in near silence.

While the procedure may not result in the major scarring of traditional invasive obesity surgery, it’s not without some risk. Side-effects generally extend to a sore throat and nausea and some have complained of temporary pain in their shoulder, and it is not a miracle cure all.

“The folds reduce the amount of food which can be held in the stomach so it makes patients feel fuller faster,” says Mr Halstead.

“However, to realise the full effects patients still have to commit to diet and exercise; you don’t wake up slim.

“It is too early to estimate the success rate, but patients should begin to see weight loss within the first four weeks and immediately they should experience an earlier feeling of fullness. Surgery is not a quick-fix option, but for people who have tried everything else it can provide a life line.”

An hour and 12 minutes after surgery began, Mr Halstead completes the last and 13th fold and makes a final check of his work. A team in Southampton which has been using the equipment a little longer have reduced the operation time to around 50 minutes.

“What you see on the monitors is deceptive,” he says, pointing to a series of neat, if apparently small folds. “Actually we have reduced the stomach capacity by a significant amount, enough for the patient to feel a real difference straightaway.

“To be able to help patients, while at the same time reducing the risk of infection and reducing pain has to be a good thing.” The day after her surgery, Andrea, who has her own target weight of nine stone, says she feels a little sore. She was allowed to go home in the early evening, but has so far only managed to drink a small amount of water and a cup of tea.

“It’s worth putting up with a little discomfort. I honestly believe that this surgery could change my life and I know there are many other people out there like me who could be helped.

“Since I had my first consultation I never had any doubts that it was something I wanted to go ahead with. It just felt so right. There is a long road ahead, but I feel really positive about the future. I read that after surgery there was one person who not only lost their taste for chocolate, but developed a craving for salad. Now that would be a result.”
 

dottychic

New Member
Great read Kevin, the POSE is very interesting and used in the right way could save the NHS millions that it would cost them if overweight people were left to be morbidly obese.....sadly as the Prof says, the NHS is mostly too shortsighted to see this :D XX
 

Miss Tickle

Well-Known Member
Very interesting read, thanks Kevin. It seems more affordable then band and bypass. I think I'll do a bit more research to check the expected weight loss as the prof seems a bit vague on that aspect!
It appears that it reduces stomach capacity but does not affect absorption. I guess weight loss would be a bit slower but it may be a healthier long term option. I'd love to hear from if anyone has has it done and how they're doing.
 

von

Member
Very interesting read, thanks Kevin. It seems more affordable then band and bypass. I think I'll do a bit more research to check the expected weight loss as the prof seems a bit vague on that aspect!
It appears that it reduces stomach capacity but does not affect absorption. I guess weight loss would be a bit slower but it may be a healthier long term option. I'd love to hear from if anyone has has it done and how they're doing.

Check on the thread entitled POSE started by Thinkingman. There's a lot of info on there.

The long term weight loss is unknown in the sense that there are as yet no long term statistics as it's so new. However, for a woman it would be in the region of at least 3 stone and more for men.

You do have to bear in mind though that this procedure is only aimed at people with smaller BMI's (under 40).
 

shelbell

Proudly maintaining
The estimated expected weight loss I have read is only 30-40% EW but that would depend on compliance. The POSE thread (in the introductions section) makes for interesting reading.

Sent from my iPhone using Forum Runner
 

Bev

New Member
Great read Kevin, the POSE is very interesting and used in the right way could save the NHS millions that it would cost them if overweight people were left to be morbidly obese.....sadly as the Prof says, the NHS is mostly too shortsighted to see this :D XX

Absolutely Jac... thanks for posting Kev xxx
 
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