Surgery can play a bigger part in fight against obesity, say doctors

Gastric surgery can play a bigger role in helping obese people lose weight, a Glasgow surgeon has said.

David Galloway, a consultant surgeon at Gartnavel Hospital and honorary Senior Lecturer at the University of Glasgow, will tell a conference on obesity next week that procedures such as gastric band surgery have a bigger role to play in tackling the condition.

Obesity is a growing problem in Scotland. It is estimated that 30 percent of the adult population will be clinically obese by 2010. The inaugural conference on May 5 at the Royal Concert Hall in Glasgow is the first time doctors, nurses, dieticians, psychologists and other health professionals have come together to discuss bariatric surgery solutions to obesity.

Gastric band surgery is the most-common bariatric procedure for obese patients in the UK and involves placing an inflatable band round the top of the stomach, effectively reducing its capacity, making a patient feel full sooner. It is performed using keyhole surgery and is reversible making it one of the safest operations of its kind.

Mr Galloway, who will speak at the conference organised by the Department of Nursing & Healthcare at the University of Glasgow, said: “Surgery should not be considered as a first or easy option but for selected patients who have genuinely failed to succeed with conservative measures it is an attractive option.

“Weight control plays a huge part in minimising the risks of other obesity related diseases but for those people who have been unsuccessful in losing weight by other means, such as dieting and exercise, surgery can help.”

Obese patients often suffer from other health problems such as type-2 diabetes, hypertension, coronary artery disease and respiratory disease. Obesity is also linked to the risk of a number of different cancers. For severely obese subjects, life expectancy is significantly shorter than the national average.

Mr Galloway said: “Gastric band surgery is safe and effective and gives good results. It also has the potential to allow patients with type-2 diabetes to go into remission, reducing the risk of cardiovascular, renal and ophthalmic morbidity which can ensue.

“Some even think that type-2 diabetes should now be considered a ‘surgical disease’ as the best medical treatment can do is little more than manage the progression of a chronic condition whereas surgery could potentially control a large proportion of suitable patients.”

Previous studies have shown that patients undergoing bariatric surgery see a greater reduction in weight for at least eight years and usually lose between 50-75 percent of their excess body weight.

“Surgical intervention is currently the only available effective therapy for the long term control of morbid obesity and will become a major weapon in the fight against it,” said Mr Galloway. “It might seem an expensive option, but when compared to the cost of obesity and its associated health problems it is a cost-effective solution.”

Professor Naveed Sattar, Professor of Metabolic Medicine at the University of Glasgow agrees. He said: “The benefits of obesity surgery are increasingly apparent and include a 30-40% reduction in mortality, including fewer heart and cancer deaths, as well as improvements in quality of life.

“As the evidence base has improved, there is a perhaps greater incentive to consider surgery in selected patients, especially in those in whom genuine cost and significant quality of life benefits are likely.  However, at the same time as capacity for obesity surgery is inevitably enhanced, more funding must be targeted in helping prevent obesity.”

The number of bariatric surgery procedures, including stomach stapling, gastric bypass and sleeve gastrectomy, increased by 40 percent last year to 2,724, according to the NHS Information Centre. In 2006-2007 the NHS also dispensed 1.23 million prescriptions for obesity drug treatments, an increase of 16 percent on the previous year.

The conference: ‘Obesity, Bariatric Surgery and Weight Management: Discoveries and Challenges’ takes place on Tuesday, May 5 at the Royal Concert Hall in Glasgow.

For more information contact Stuart Forsyth in the University of Glasgow Media Relations Office on 0141 330 4831 or email s.forsyth@admin.gla.ac.uk

First published: 30 April 2009

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