This page describes the reality of the current obesity epidemic and the weight loss surgery (WLS) approach to the problem.

Obesity and weight loss is about far more than a concern regarding your looks.


It is now widely accepted that having excessive weight for your  height (measured by calculating the body mass index, BMI, which is your weight in kilograms divided by the square of your height in metres) puts you at increased risk of developing high blood pressure, diabetes mellitus, arthritis, obstructive sleep apnoea, heart failure, and a shortened life expectancy. Obesity is increasingly recognised as the leading "disease epidemic" of the 21st century in the developed world.


Normal BMI is in the range 20-25. People with a BMI between 25 and 30 are termed "overweight", those with a BMI between 30 and 35 are "obese". People with a BMI greater than 35 are termed "morbidly obese", and with a BMI greater than 50, "super-morbidly obese". BMIs greater than 100 have been recorded, but are not compatible with life in the long run.

Obesity is now rapidly increasing in the UK, associated with fast food consumption, a stressful work environment causing widespread depression, and a more sedentary lifestyle. The harmful effect of the first mentioned alone is well illustrated by Morgan Spurlock's infamous documentary "Super-size me".



For people affected by obesity and the medical problems mentioned above, weight loss (as long as it is not excessive) has been shown to improve physical health and prolong life. But, as everyone knows, losing weight and maintaining weight loss is a major challenge.

Healthier foods, more exercise, diets, medication, hypnotherapy, and many other approaches are being actively promoted. Yet the overall success rate of "lifestyle changes" is less than many people would hope for. The answer may well lie in our genetic makeup - scientists are now beginning to isolate genes responsible for regulating appetite and metabolism which, in a proportion of the population, may effectively doom all attempts at weight loss. It is beginning to become accepted that, just like some people cannot gain weight no matter what they do (see the recent BBC Horizons


Surgical solutions have been developed which reduce the gut's ability to either take in or absorb food. Initially this involved major replumbing of the intestine - operations which necessitate several hours of surgery and a week's hospital stay, and are irreversible. These are still performed today in many centres, and their dreaded complication rate has fallen significantly. Gastric bypass, Roux-en-Y, and duodenal switch induce permanent life-long malabsorption of food. Patients have to adjust their regular diet and must guard against deficiencies of protein, vitamins and minerals. Such operations leave large scars when performed as open surgery. The advent of keyhole surgery has now made it possible to perform these operations less invasively, but they remain irreversible.

For the past decade, however, an alternative approach has become increasingly popular and is now the mainstay of bariatric surgery worldwide: The adjustable gastric band (AGB)

A good overview of the AGB approach can be found here: Adjustable gastric band  (Wikipedia).