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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