Weight loss surgery

Why diets don't work

Have you ever wondered why losing weight is so difficult? After all, everybody knows that in order to lose weight we have to watch what we eat and do more exercise. Have you ever wondered why despite the fact that you are able to lose weight that you just find it simply impossible to keep the weight off over the long term? You are not alone in this.

Weight regain

Studies have shown that while patients on diets, exercise programmes or medication can lose about 10% of their body weight, they tend to regain 2/3 of it within one year, and almost all of it within five years.

THE “yo-yo dieting” phenomenon usually results in gradual weight increase as the years go by.

This shows that dieting for the vast majority of people is a futile effort and becomes an on-going battle between your brain and your body. This is an exhausting cycle which is called the “yo-yo dieting” phenomenon & usually results in gradual weight increase as the years go by. This is not only physically damaging in the long term but also has major physiological and emotional impacts on people who are in a constant struggle with their weight.

It is not uncommon for people to say to me that they have been very successful with weight loss in the past but they found themselves constantly hungry and lacking in energy.

Hunger is a very powerful bodily reaction

No diet has been created that successfully deals with these issues. Hunger is a very powerful bodily reaction and was ultimately designed to help the human race survive. It is obvious that in present day society where high calorie, energy dense food is readily available, keeping a check on our weight is a major challenge for a lot of people.

Don’t despair! If you are one of these people for whom diets have been unsuccessful and your weight bothers you, either physically or mentally, then it is worthwhile considering Bariatric Surgery. Bariatric Surgery not only achieves better weight loss than diet and exercise modification alone, but it addresses hunger and allows life to take on a whole new focus without body weight issues being an on-going battle. Stomach stapling, Lap Band, Gastric Banding, Gastric Sleeve or Bypass surgery are terms referring to different types of Weight Loss surgery. They all have pros and cons and what suits one person may not suit another. The fact that you are reading this means that you would probably like more information! Read on… or phone us to make an appointment to speak through the options in greater detail. I look forward to hearing from you!

Research has shown that addressing your weight with surgery can prolong your life as a result of becoming healthier and improving or even curing comorbidities.

Do I need surgery?

It probably comes as no surprise to you that the incidence of obesity in New Zealand has reached epidemic proportions! Recent survey data has shown that 2/3 of New Zealanders are overweight or obese and this proportion is increasing year upon year. This growing national health problem generates a significant burden of disease, culminating in an increased risk of chronic illness as a result of Hypertension, Type 2 Diabetes, Sleep Apnoea, Respiratory problems, Coronary Artery Disease, Stroke, Gallbladder Disease, Osteoarthritis, Cholesterol problems as well as cancers of the Endometrium, Breast, Colon and others.

2/3 of New Zealanders are overweight or obese

Whilst there are a lot of things that need to be addressed on a population basis, such as access to high calorie, sugar filled foods and advertising restrictions amongst other things, at the end of the day it all comes down to YOU and what you are going to do for your situation.

Surgery for health brain and body

The question of whether you need surgery is one that only you can answer. However, there are many reasons why people choose to have surgery for long term sustained weight loss. Some of these may include giving them a chance to cure their Type 2 Diabetes or to delay or even avoid joint replacement surgery for example. Medical issues, as a result of being overweight take time to develop, so for others it is not so much the physical concerns. Rather, it is an emotional decision. Being self-conscious about your body habitus can have a very limiting effect on the way you live your life and the activities you can indulge in.

I often hear that “I find myself saying no to invitations to social events” or “I just want to be able to do things with my children”. This is all about being able to participate fully in life again and taking away the ‘hand brake’ in their lives. For these people weight loss surgery is just as legitimate an option. For these people it is the key to having the freedom to live their life without the constant issues around food and eating.

“I find myself saying no to invitations to social events”

So the question of whether you need Bariatric Surgery is a very difficult one and only one that you can answer ultimately.

Research has shown that for people with morbid obesity, addressing your weight with bariatric surgery and losing significant amounts of weight can prolong your life as a result of becoming healthier and improving or even curing comorbidities.

This is something that weight loss surgery has been proven to achieve better than any other treatment or diet on its own.

It is my role to provide you with as much information as you need on the types of surgery (including Gastric Banding, Gastric Sleeve, Gastric Bypass, Duodenal switch etc) in order to make your decision - as this is one of the biggest decisions you will make in your life. A Consultation is often the best way to talk through your individual situation in order to help you in your decision making process.

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BMI calculator

The Body Mass Index (BMI) is a calculation of the ratio between your weight and your height.
The formula is used to determine the amount of body fat you carry and it is the best measure
of obesity that we have.

Calculate your BMI now

Do I qualify for surgery?

The decision to have Bariatric Surgery is a big one and one that usually takes time to process. The question about whether an individual qualifies for surgery is one that I get asked frequently. Of course the decision to finally go ahead with surgery is an individual one and one that is based on the potential benefits of surgery for that individual versus the risks of the actual operation.

A good starting point is to work out your BMI. This can be done easily using a BMI calculator like the one above. This gives you an objective assessment of your body weight for your height and allows you to see which category you fall into. Generally speaking, I would not advocate surgery for people with a BMI less than 30 as the risks of the surgery usually outweigh the benefits that can be gained from a medical or physical perspective.

For people on the other end of the BMI spectrum (ie those with a BMI in the 60's) it is about making the surgical experience as safe as it can be.

Bariatric surgery is certainly an option for people with this sort of BMI, as this will allow more weight loss than could otherwise be likely to be achieved with non-surgical weight loss efforts by far. However,the risks of an operation are serious and need to be addressed. My approach is to arrange for a thorough medical assessment to identify risks that may lead to complications and address the issues thoroughly before surgery is undertaken.

It is essential to minimise risks as much as possible in order to make the surgical experience as safe as it can be.

There are lots of other considerations that need to go into the question of whether surgery is right for you, and qualifying for surgery is only one of the first ones! A consultation is a good way of going through all of these issues in a concise and straightforward way. At the end of the day, Google is the starting point for most peoples journey to Weight loss surgery but a consultation with me (your Bariatric Surgeon) will help you to process the information for your personal situation.

What types of surgery are there?

Gastric Band

An inflatable band is placed around the upper part of your stomach and stitched into position. This limits the portion sizes you eat, decreases the calories you take in whilst giving you a feeling of fullness that lasts between meals.

The band is inflatable & deflatable via a plastic port that sits under your skin. This allows the band to be adjustable, which is a fundamental characteristic as this enables patients to continue to lose weight. Band adjustment, is required 4 to 6 weekly in the 1st year to maintain a steady rate of weight loss. The operation is reversible which means that if the band is removed then the GI tract anatomy returns to normal.

Average weight loss 40 to 50% excess weight loss
Follow up necessary 4-6 weekly band adjustments for the first 12-18months
Nights in hospital 1
Re-operative surgery About 20% over 10 years
Serious complications Rare >1%
Death following surgery 0.1%

Gastric Sleeve

The size of the stomach is reduced to a narrow tube, a 'sleeve'. This limits the portion sizes you can eat. It also gives you a feeling of fullness after eating a small amount of food.

Average weight loss 60 to 70% of excess weight loss
Follow up necessary One check up 4 weeks after operation then as required
Nights in hospital 2 or 3
Re-operative surgery Unknown but probably <5%
Serious complications 2 to 5%
Death following surgery 0.5%

Single Anastomosis Duodeno-Ileal Bypass (SADI)

The SADI is often used as a second procedure after a Sleeve Gastrectomy. It is a type of bypass operation whereby a length of small intestine is bypassed. This means that your food is not going through the entire length of the small intestine (similar to the gastric bypass) and has a malabsorptive component. It uses a single join up between the small intestine and the duodenum.

A Gastric Sleeve is performed first (if there hasn’t already been one) and then the bypass after that. It is a calculated malabsorptive operation and has a stronger malabsorptive component to it than the Gastric Bypass. For this reason, it is essential to be taking vitamin supplementation long term with the SADI and have a yearly nutrition blood test at least. It is great as a primary operation or as a secondary surgery after a Gastric Sleeve.

Average weight loss 70 to 80% excess weight loss
Follow up necessary Consultations at 3 weeks post-op, then 3 months, 6 months and yearly after that. Nutrition blood tests pre-surgery, 3 months post-op and then 6 months and yearly.
Nights in hospital 2
Re-operative surgery Very low
Serious complications <2%
Death following surgery <0.5%

Gastric Bypass

The stomach is reduced in size to a small pouch and then reconnected to the small intestine further down the GI tract. This essentially bypasses the distal stomach, duodenum and first part of the small intestine. The small gastric pouch means that you are restricted to eating smaller portions and the re-routing of the GI tract means that the foods you eat are not absorbed as effectively as normal. Both of these aspects contribute to weight loss.

Average weight loss 60 to 70% of excess weight loss
Follow up necessary 3-6 monthly blood tests checking for malabsorption of essential vitamins and minerals
Nights in hospital 2
Re-operative surgery About 5-10% over 10 years
Serious complications 5 to 7%
Death following surgery 1%


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