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Weight management options: from support to surgery

Our weight and eating habits have been brought more into focus over the last year. Not only have we continually heard the news about links between obesity and poorer outcomes with COVID-19, but the lockdown restrictions have significantly impacted upon our daily routines, work, social life and exercise habits. Here, Nuffield Health Bristol Hospital’s expert team of weight loss specialists offer advice on the options available.

We know that weight management is more than simply making changes to diet and exercise; it is also impacted upon by stress levels and sleep, as well as other physiological factors such as our endocrine system, genetics and gut hormones. So, the worry associated with the pandemic as well as the changes to our habits from the lockdown restrictions have taken their toll on our weight and fitness. It has been the perfect storm for weight gain. Social media is flooded with discussion about lockdown weight gain which reflects peoples’ increasing worry about their health. If you were already struggling with your weight prior to the pandemic, it is likely that it feels significantly more difficult now.

Working from home also offers challenges. By removing the boundaries around mealtimes and breaks, we can wander into the kitchen throughout the day and mindlessly grab something to eat, or skip lunch due to the change in routine. Both a grazing style of eating and skipping meals make it harder to manage weight.

As a result of these factors, many more people are seeking help to refocus their eating and self-care routines. Our team of weight management specialists at Nuffield Health Bristol Hospital are able to provide a range of interventions to suit different types of challenges that people face. These specialist interventions include:

Wellness Support
Research tells us that 95% of people who reduce their weight through calorie restriction alone, regain all of their weight (and usually more) over a 3-year period. Our Wellness support therefore, focuses on building a psychological understanding of the way our mood, stress and habits impact on our eating, nutrition and weight. It is the broadening of focus that has been found to be most beneficial to longer term weight management rather than repeating old patterns of dieting.

Medication for Weight Loss
There have been significant developments in the medication used for weight loss. We prescribe Saxenda© (Liraglutide) which is similar to a hormone found naturally in our body. It works to reduce feelings of hunger whilst increasing a sense of fullness, activating areas of our brain that regulate appetite. When Saxenda is used as part of a weight management programme, people typically lose between 5-10% of their body weight in the first 16-weeks.

Elipse Balloon
The Elipse Programme™ provides a combination of a state-of-the-art gastric balloon alongside dietetic and psychological support over a 4-month period. It does not require any surgery, endoscopy or anaesthesia and is placed in a brief, 20-minute appointment. The balloon is filled with a fluid and remains for approximately 4 months before passing naturally. On average people lose between 13-15kg in weight.
Having an Elipse balloon at Nuffield Health Bristol Hospital also enables access to some of their gym facilities and a fitness assessment during the period of the programme. This approach tackles all of the elements that have been found to help with weight loss.

Bariatric surgery
The most effective means of sustainable weight loss comes from bariatric surgery. Our team includes experts in their field of surgery, dietetics and psychology. We are proud of our approach at Nuffield Health Bristol Hospital, in which we ensure that the procedure is right for you, with access to comprehensive multi-disciplinary support, both pre- and post-operatively. We know, through understanding of research and years of clinical practice, that the most effective long-term outcome requires a more comprehensive approach to changing the way that you take care of yourself, as well as the highest standard of surgical care.

We offer the following procedures, all performed laparoscopically using keyhole surgery:

• Gastric Bypass
This procedure involves creating a small pouch at the top of the stomach, which is then connected to the small intestine. As a result, the rest of the stomach is bypassed. By doing so, it not only reduces the amount that a person is able to eat but it also changes the gut hormones which are linked to hunger and feeling of fullness. It results in rapid weight loss in the first 6-months before stabilising over time.

• Sleeve Gastrectomy
This procedure removes a large section of the stomach, leaving a ‘banana-shaped’ section that is closed with staples. It reduces appetite in the short-term, as well as reducing the amount of food that can be eaten. Like the bypass, it also affects the gut hormones.

• Gastric Band
This uses a device that is placed around the top of the stomach, creating a small pouch. It is connected to a port placed under the skin so that fluid can be added to the band to adjust the pressure. It helps to make changes to the way a person eats, as well as enabling an earlier sensation of fullness.

• Revision Surgery
We also offer surgical support to individuals who are looking to revise or manage previous bariatric surgery.

If you would like further information about the support we can offer you, join us for a free online information session to meet the team on Wednesday 23 June at 7pm. To book a place on this meeting, or if you have any questions, please contact the Enquiries team at Nuffield Health Bristol Hospital by calling 0117 911 5339, or visit our website: nuffieldhealth.com/hospitals/bristol

Main image: Nuffield Health Bristol Hospital’s team of weight management specialists; consultant bariatric surgeon Mr Alan Osborne, consultant clinical psychologist Dr Vanessa Snowdon-Carr, dietician Dafydd Wilson-Evans, and consultant bariatric surgeon Mr James Hewes.