Sue Marshall blogs about diabetes for Desang

Weight Loss Surgery Can Lead To Psychological Distress

April 21, 2010
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Gastric banding is an extreme solution at best, but for some people with obesity and diabetes it’s available.

People who have gastric band surgery to lose weight are at risk of low self-esteem, relationship problems and being dissatisfied with their body image, according to new research being presented at the Diabetes UK Annual Professional Conference (APC) today.

Researchers from the University of the West of England and Southmead Hospital, Bristol, followed 25 patients, aged from 30 to 58 years, and recorded their experience 12 months after receiving a post-laparoscopic gastric banding operation. 64 per cent of the participants had Type 2 diabetes.

Although the people who took part in the study reported significant health benefits such as improved blood glucose levels and lower cholesterol and blood pressure levels, they also found that living with the gastric band had a strong, negative psychological impact on their daily lives. The majority reported that having a gastric band was as hard as having to diet and that losing the opportunity to eat as a coping strategy left them struggling to deal with distressing life events.

Lead researcher Dr Andrew Johnson from Southmead Hospital said: “Our findings show that having a gastric band fitted should not be seen as the easy option when it comes to losing weight. This operation has a strong psychological impact as well as a physical one and we found that regular psychological support is needed to help people cope with the realities of having the device fitted.”

Simon O’Neill, Director of Care, Information and Advocacy Services at leading health charity Diabetes UK, said: “Losing weight not only reduces your risk of developing Type 2 diabetes but also significantly improves management in those who have the condition. We always advise people wanting to lose weight to try to do so by following a healthy, balanced diet high in fruit and vegetables and low in fat, sugar and salt combined with physical activity. Weight loss surgery can be a way of losing significant amounts of weight for people who are obese. However, surgery does have serious associated risks and should only be considered if sustained attempts to lose weight through diet and lifestyle changes have been unsuccessful. This new research also shows that there might be psychological consequences to having the procedure and patients should be made aware of these when considering the surgery.”

The NHS Information Centre recently released figures showing a 55 per cent increase in the number of people having weight-loss surgery, such as stomach stapling or having a gastric band fitted, between 2006/07 and 2008/09, from 1,950 to 4,220.

via: Weight Loss Surgery Can Lead To Psychological Distress


The more you weigh the more likely you are to underestimate your true size, according to new research

April 15, 2010
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They say the camera adds ten pounds… perhaps the mirror does too?

The more you weigh, the more likely you are to underestimate your true size, according to new research that reveals fascinating insights into the way severely overweight patients undergoing assessment for weight loss surgery see themselves.

According to the study, carried out by leading bariatric (weight loss) surgeon David Kerrigan and his team at Gravitas, 50% of patients surveyed had a distorted perception of their body image, making them unable to identify their correct body shape when shown a selection of images ranging from underweight to massively obese.

Yet while one in three patients with a body mass index (BMI) under 50 in this group overestimated their size, over three quarters of those who had a BMI over 50, ie the super-obese, thought they were actually lighter than they were.

As Mr Kerrigan points out, the findings may explain why certain patients allow themselves to go on gaining weight when they are already clearly massively obese.

“What is particularly interesting about these findings is that having a BMI of over 50 seems to represent a threshold that once crossed is associated with denial, underestimation of weight gain and thus progression to ever-more severe degrees of obesity,” says Mr Kerrigan, who advised the government on the NICE obesity guidelines used today.

“It is perhaps not surprising to discover that some lighter patients with a weight problem think they look bigger than they do. This may be because they feel guilty, embarrassed and dogged by low self-esteem and depression, and therefore have a tendency to an exaggerated perception as to how large their body is.

“But there seems to come a point at which patients start to bury their heads in the sand and go into denial about the true extent of their weight problem, which may lead them to abandon on-going attempts at weight control,” adds Mr Kerrigan, who is medical director at Gravitas.

For the study, Gravitas researchers asked 112 patients undergoing assessment for weight loss surgery to identify their correct body shape from a selection of standardised silhouettes ranging from underweight through to massive obesity.

The survey revealed:

• Half (50%) of all obese patients surveyed could not correctly identify their current body shape
• This distorted self-perception was most marked in the super-obese (BMI >50), over three quarters (77%) of whom were unable to identify their true body shape with any degree of accuracy
• All super obese patients who were unable to identify their body image correctly underestimated their size
• Of the one in three obese patients with a BMI under 50 who incorrectly identified their body shape almost all overestimated their size

Mr Kerrigan added that a reassuring finding from the study was that most patients had realistic expectations of what weight loss surgery can deliver, although a third wanted to end up with a normal body mass, something weight loss surgery rarely delivers. However, a worrying 5% chose a silhouette that was underweight when asked to identify the body shape they felt represented an ideal outcome from surgery.

“This simple screening technique may prove useful in identifying the small number of patients with significant mental health issues manifesting themselves as a desire for extreme degrees of post-operative weight loss, who should be guided towards psychological support rather than surgery in the first instance,” said Mr Kerrigan.

The findings of the study were presented recently at the inaugural Scientific Meeting of the British Obesity and Metabolic Surgery Society (BOMSS), which awarded Gravitas the BOMSS Council Prize for the best research presentation. ENDS

Notes to editors:
A person is classified as obese if they have a BMI (body mass index) greater than 30 and morbidly obese if it is more than 40. A person with a BMI over 50 is classified as super obese. Surgical candidates should have a BMI of at least 35 (if they have other medical problems) or 40 (if they do not). A healthy BMI is between 18.5 and 25. A person’s BMI is calculated by dividing their weight in kilograms by their height in metres squared.

About Gravitas (
Gravitas is a network of doctors and surgeons in the UK and Ireland committed to working to the highest ethical and professional standards in bariatric surgery. Awarded the prestigious ‘team of the year’ accolade for innovative surgical practice by the independent Association for the Study of Obesity in 2009, Gravitas treats both private and NHS patients and has helped train many bariatric surgeons in the UK through its fellowship programme for senior surgical trainees.

About Mr David Kerrigan
MD with Distinction (1992), FRCS, FRCSEd (1986), MBChB (1982)
Honorary senior lecturer in surgery at the University of Liverpool, Mr Kerrigan practises at the Spire Murrayfield Hospital, Wirral and is amongst the elite of UK bariatric surgeons. He is also medical director of Gravitas. Widely respected by both the public and his surgical peers for his technical skill and commitment to uncompromisingly high standards of bariatric care and aftercare, David Kerrigan is a pioneer of laparoscopic (keyhole) bariatric surgery in the UK and has lectured widely on this subject both here and abroad. His work has been featured in numerous television and newspaper reports.

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