CHRIS PRING Consultant Bariatric Surgeon

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CHRIS PRING Consultant Bariatric Surgeon

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1. CHRIS PRING Consultant Bariatric Surgeon

2. Definitions Body Mass Index = weight/height2 < 20 = underweight 20-25 = normal 25-30 = overweight 30-40 = obese > 40 = morbidly obese Excess Weight = Current Weight – Ideal Weight

3. BMI > 30 1991

4. BMI > 30 1992

5. BMI > 30 1993

6. BMI > 30 1994

7. BMI > 30 1995

8. BMI > 30 1996

9. BMI > 30 1997

10. BMI > 30 1998

11. BMI > 30 1999

12. BMI > 30 2000

13. BMI > 30 2001

19. Obesity Related Mortality

20. What Are The Common Treatment Options?

21. Conservative Treatments Weight watchers Slimming world Hypnosis Atkins diet Medical Treatment Orlistat Sibutramine Surgical Treatment

22. What Can We Offer? Specialist Multidisciplinary Weight Loss Programmes Intragastric Balloons combined with specialist multidisciplinary weight loss programmes Surgery laparoscopic gastric band laparoscopic gastric bypass laparoscopic sleeve gastrectomy

23. Specialist Multidisciplinary Weight Management Regular multimodal therapy dietitians psychologists exercise physiologists 6 month tailored programme 1-2lbs per week (0.5-1kgs) Achievable. Realisitic. Significant. eg 10% EWL will reduce diabetes risk by half

24. Intragastric Balloon In the setting of a multidisciplinary weight management programme Mean = 32% EWL at 6 months Probably most effective in BMI = 27-40 kg/m2

25. Laparoscopic Gastric Band Mean = 47% EWL Best for BMI < 47 kg/m2 Regular meal patterns Non sweet eaters Mortality risk 1:800 Morbidity risk 1:100 15% bands need revision

26. Laparoscopic Gastric Bypass Mean = 72% EWL Best for All BMI Sweet eaters and grazers Diabetics Mortality risk 1:300 Morbidity risk 1:75

27. SUMMARY

28. Obesity Related Mortality

29. TREATMENT OPTIONS Specialist Multidisciplinary Weight Management Programmes >10% EWL Intragastric Balloon 32% EWL Laparoscopic Gastric Band 47% EWL Laparoscopic Gastric Bypass 72% EWL

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