The Live Life Better Pre-Surgery Programme
The first step
If you are interested in surgery to help with weight loss, you should first discuss this with your GP. There are strict criteria about who can be referred for bariatric surgery and your GP will be able to discuss these with you and advise you about the current situation in your local area and whether or not you are eligible. If you are eligible, your GP will be able to tell you more about the options available, the associated risks and benefits, and help you decide whether this is the right choice for you.
General information about surgery for weight loss can be found here http://www.nhs.uk/conditions/weight-loss-surgery/pages/introduction.aspx
Information is also available from the Derby bariatric surgery team http://www.derbyhospitals.nhs.uk/about-us/departments-services/bariatric-surgery/ and Sheffield bariatric surgery team http://www.sth.nhs.uk/services/a-z-of-services?id=239 which includes information about the three different procedures available: Gastric bypass operation http://www.sth.nhs.uk/clientfiles/File/GastricBypass.pdf, Laparoscopic banding operation http://www.sth.nhs.uk/clientfiles/File/LaparoscopicGastricBandingOperation.pdf, and Sleeve gastrectomy http://www.sth.nhs.uk/clientfiles/File/SleeveGastrectomy.pdf
Watch a short animated clip of how the internal organs are altered during bariatric surgery using laparoscopic banding operation, gastric bypass and sleeve gastrectomy (links to animated clips).
If your GP agrees that surgery could be a useful option for you, and you meet the criteria for referral (including having stopped smoking for at least 6 weeks), you will be referred into the Live Life Better (LLB) pre-bariatric 8 week programme.
What to expect on the LLB Pre-surgery programme
Everyone who is referred for surgery needs to have completed the LLB pre-surgery programme. As well as supporting you to lose weight using a Life-style approach, this programme will also give you basic information about bariatric surgery and help you begin preparing you for the changes you will need to make before and after surgery, should you choose to go ahead with this.
“I think they prepare you well for surgery. They let you see what you need to be doing to lose weight. They also give you skills which you can apply to other problems that you may have. (Skills for life). They made it possible to take control of my life again”
Accurate information
You may be interested in surgery but not know much about it, or you may have some knowledge from things you have read, heard from other people or seen on TV. The option of surgery might have been suggested by your GP and you might be feeling a bit unsure or scared about the idea. On the LLB pre-surgery programme:
· You will receive the right, accurate information and more opportunity to talk about bariatric surgery to help you make an informed choice about whether this is the right option for you.
· You will have the opportunity to experience using an individualised lifestyle approach to weight loss with the support of the LLB team, which can help you successfully lose weight whether you eventually choose to have surgery or not.
Guidance for successful surgery
You may already know a lot about surgery for weight loss and be sure that this is the right decision for you. LLB might feel like just another “hoop” to jump through on the way to getting what you are sure you really want. However for bariatric surgery to work well for you to produce long term weight loss you will also need to make significant and permanent changes to your lifestyle. We can help you begin to make these changes before surgery; to prepare yourself for the impact this will have on you and your life and to offer you support and guidance to help you succeed. We offer you:
· The opportunity to learn more about your relationship with food and make changes that will increase chances of successful long term weight loss after surgery.
· Support to lose weight prior to surgery which makes the procedure safer.
· The possibility of alerting your GP and the surgery team to any particular needs you may have which will enable them to provide you with better support in preparation for surgery and afterwards.
· The opportunity and support to increase your activity levels
At 8 weeks
We usually review how things are going at 8 weeks. The psychologist and support worker will be interested in your thoughts about how you think things are going, what’s working well, any difficulties. There are a few more questionnaires to fill out, and we ask to weight you.
You can lose as much weight as you are able to between your assessment with LLB and referral for surgery without jeopardising your chances of being referred and offered surgery. In fact, weight loss prior to surgery is actively encouraged and improves your chances of being offered the procedure as it demonstrates commitment and the ability to work well with the health professionals supporting you.
What happens next
We will write to your GP to summarise your progress on the programme and highlight any areas which we feel need further attention.
We aim for all patients to have achieved a 2% weight loss at this point in order for us to be able to support your GP in making a referral for surgery. However, ultimately the decision about whether you are referred for surgery lies with your GP, and the decision about whether you are offered surgery lies with the surgeon.
This point marks the end of our contact with you. Further input to support you in preparing for and coping with surgery will be provided by your GP surgery and the Bariatric surgery team in Sheffield http://www.sth.nhs.uk/services/a-z-of-services?id=239 or Derby http://www.derbyhospitals.nhs.uk/about/depts/bariatric-surgery/?locale=en
Support groups, provided by both the Sheffield and Derby bariatric surgery teams are a good place to meet other people at different stages of their bariatric surgery journey. They can be a good source of information about what life is like in preparation for, during and after the procedure.
Some patients change their mind at this point, or even before, about how they want to manage their weight and they decide to transfer onto our Life-Style programme rather than taking the option of surgery.
“I started the LLB service only as part of the process of being accepted for gastric band surgery. I was an emotional mess and could see NO possibility of losing weight on my own. LLB service has been life changing for me. I have lost 10% of my body weight in 4 months = 2 stone 2 lbs. I have been able to change my attitude to food/exercise for the first time in my life and I no longer want gastric surgery and so have saved the NHS money. Their support is invaluable to me”