Bariatric Surgery

Information Leaflet

How do you get referred for Surgery?

As you know all patients living in Plymouth requiring NHS Bariatric Surgery have to attend the Weight Management Clinic and complete 3 months of the program prior to consideration for referral. This is to ensure that you can make the necessary lifestyle changes required before and after surgery which will help to make it more successful for you. The pathway is then as follows:

  • Review appointment with Nurse Specialist
  • Attend Pre-Assessment Group Session with Dr English, Consultant Endocrinologist/Diabetologist
  • Full clinical assessment appointment with Dr English
  • MDT discussion between Dr English and Team.
  • Referral to Derriford (You will then be offered and appointment with the Surgical Team at Derriford and pre-op assessment prior to your operation being performed)

Surgical Referral Criteria

BMI is over 35kg/m2 if you also have medical conditions that would be improved by weight loss such as diabetes, high blood pressure, high cholesterol or sleep apnoea. Without comorbilities, your BMI needs to be over 40 kg/m2

  • Completion of Initial 3 months
  • Non smoker
  • You have made serious attempts to lose weight with other methods
  • You are prepared to make substantial changes to your eating habits and lifestyle
  • You will need to lose 10% of your total body weight prior to referral

How surgery works

The human body lays down fat stores if the calories in the food you eat exceed the energy you burn up. There are a number of complex processes which the medical profession is only just starting to understand that seem to contribute to increasing obesity - the appetite mechanisms go wrong and you continue to eat even though you do not need the calories. And of course, once your body is carrying the extra weight, it becomes harder to be physically active which would help to regulate your weight.

Depending on your individual weight problem and health goals, the decision as to which route you go down is made jointly between you and the team. Briefly, there are two modes of action of weight loss surgery:

  • Restrictive operations cause weight loss by reducing the amount of food that can go into your stomach. This makes you feel full very quickly, removes hunger and reduces the need to eat. The gastric band is the simplest form of obesity surgery and works by restriction.
  • Operations that cause malabsorption reduce the amount of food that can be digested by the intestine. Restriction and malabsorption effects are combined in the gastric bypass operation.

The amount of weight loss after surgery depends both on the type of operation and your dietary habits. Success is measured as 'percent of excess weight loss'. International studies show that the average excess weight loss in the two years after a gastric band is around 50-65% and after a gastric bypass it is 65-75%. Weight losses of these magnitudes will result in a completely changed body image and improved quality of life. However, the amount of weight you want to lose is just one of the many factors that make up the decision about which operation is right for you.

BOSPA

We strongly recommend that you try and attend a BOSPA meeting. The British Obesity Surgery Patients Association (BOSPA) has monthly meetings where you can meet others who are going to have surgery or who have already had their operations. You will be able to talk to others to ‘find out what it’s really like’. All patients who have attended have found this very useful and supportive. You can visit their website at for more info.

BOSPA South Devon / North CornwallSaltash
Meeting location: Ashe Torre Hall, Old Ferry Road, Saltash, and Cornwall PL12 4GT (on the riverside underneath the TamarBridge opposite "The Boatman" pub)
Meeting frequency: Second Sunday of every month from 2.00 to 4.30pm.