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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