Information for patients

Information on weight loss procedures

Sherif Awad works in collaboration with Tonic Weight Loss Surgery to provide multi-disciplinary support for patients before and after surgery (click here to view the Tonic Weight Loss Website)

Gastric Bypass (watch an animated video click here)

The gastric bypass is a surgical procedure performed using keyhole surgery under general anaesthetic with a 1-2 day hospital stay. The bypass can (in rare instances) be reversed. The operation involves dividing the upper stomach to form a small pouch to which is attached small bowel. This allows re-routing of food to the lower parts of the intestine which leads to release of gut hormones (such as GLP-1) which have numerous beneficial effects leading to weight loss and improvement of numerous medical conditions. The bypass is designed to help maintain long-term weight loss and should be viewed as a tool to aid weight loss. To achieve a good result from surgery patients will need to implement the appropriate dietary (correct food choices) and lifestyle (regular daily exercise) modifications, and attend regular follow-up appointments in order to achieve and sustain good long-term weight loss. On average patients can expect to lose 30-35% of their total body weight over a period of 9-12 months. Additionally, the bypass has also been shown to improve multiple medical conditions such as high blood pressure, diabetes, sleep apnoea, raised cholesterol, fatty liver disease and effects of polycystic ovaries syndrome (PCOS). Most patients are able to reduce medications given for these conditions; if not come off them altogether. Following the surgery patients will need to be on (lifelong) a daily multivitamin tablet, daily calcium and vitamin D tablet, daily iron tablet and three monthly vitamin B12 injections via the GP.

To have a gastric bypass patients need to fulfil the following Body Mass Index (BMI) criteria:
BMI >30 in patients with diabetes
BMI >35 in patients with diabetes, high blood pressure, hyperlipidaemia, sleep apnoea, polycystic ovaries syndrome (PCOS), fatty liver disease, joint/back pain/arthritis as a results of obesity
BMI >40 (morbid obesity)
In certain patient groups (asian, middle eastern, african, caribbean) the BMI thresholds for surgery are reduced by 2.5 BMI points.
To find out more about the gastric bypass please contact Mr Awad’s team at info@sherifawad.co.uk
To calculate your BMI please go to: www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

Sleeve Gastrectomy (watch an animated video click here)

The sleeve gastrectomy is a surgical procedure performed using keyhole surgery under general anaesthetic with a 1-2 day hospital stay. The sleeve is not a reversible operation. The operation aims to remove 75% of the stomach allowing patients to eat small portions leading to fullness and weight loss. Additionally the operation removes the upper part of the stomach which produces ‘hunger hormones (such as Ghrelin)’ leading to reduced feelings of hunger. The sleeve is designed to help maintain long-term weight loss and should be viewed as a tool to aid weight loss. To achieve a good result from surgery patients will need to implement the appropriate dietary (correct food choices) and lifestyle (regular daily exercise) modifications, and attend regular follow-up appointments in order to achieve and sustain good long-term weight loss. On average patients can expect to lose 25-30% of their total body weight over a period of 9-12 months. The operation has also been shown to improve multiple medical conditions such as high blood pressure, diabetes, raised cholesterol, fatty liver disease and effects of polycystic ovaries syndrome (PCOS). Most patients are able to reduce medications given for these conditions; if not come off them altogether. Following surgery patients will need to take a daily multivitamin tablet, daily vitamin D tablet, daily iron tablet and three monthly vitamin B12 injections via the GP.

To have a sleeve gastrectomy patients need to fulfil the following Body Mass Index (BMI) criteria:
BMI >30 in patients with diabetes
BMI >35 in patients with diabetes, high blood pressure, hyperlipidaemia, sleep apnoea, polycystic ovaries syndrome (PCOS), fatty liver disease, joint/back pain/arthritis as a results of obesity
BMI >40 (morbid obesity)
In certain patient groups (asian, middle eastern, african, caribbean) the BMI thresholds for surgery are reduced by 2.5 BMI points.

To find out more about the sleeve gastrectomy please contact Mr Awad’s team at info@sherifawad.co.uk
To calculate your BMI please go to: www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

Mini (Loop or single anastomosis) gastric bypass (watch an animated video click here)

The mini-gastric bypass is a surgical procedure performed using keyhole surgery under general anaesthetic with a 1-2 day hospital stay. The mini-gastric bypass can (in rare instances) be reversed. The operation involves dividing the upper stomach to form a longer pouch to which is attached a loop of small bowel. This allows re-routing of food to the lower parts of the intestine which leads to release of gut hormones (such as GLP-1) which have numerous beneficial effects leading to weight loss and improvement of numerous medical conditions. The mini-gastric bypass is designed to help maintain long-term weight loss and should be viewed as a tool to aid weight loss. To achieve a good result from surgery patients will need to implement the appropriate dietary (correct food choices) and lifestyle (regular daily exercise) modifications, and attend regular follow-up appointments in order to achieve and sustain good long-term weight loss. On average patients can expect to lose 35-45% of their total body weight over a period of 9-12 months. Additionally, the mini-gastric bypass has also been shown to improve multiple medical conditions such as high blood pressure, diabetes, sleep apnoea, raised cholesterol, fatty liver disease and effects of polycystic ovaries syndrome (PCOS). Most patients are able to reduce medications given for these conditions; if not come off them altogether. Following the surgery patients will need to be on (lifelong) a daily multivitamin tablet, daily calcium and vitamin D tablet, daily iron tablet and three monthly vitamin B12 injections via the GP.

To have a mini-gastric bypass patients need to fulfil the following Body Mass Index (BMI) criteria:
BMI >30 in patients with diabetes
BMI >35 in patients with diabetes, high blood pressure, hyperlipidaemia, sleep apnoea, polycystic ovaries syndrome (PCOS), fatty liver disease, joint/back pain/arthritis as a results of obesity
BMI >40 (morbid obesity)
In certain patient groups (asian, middle eastern, african, caribbean) the BMI thresholds for surgery are reduced by 2.5 BMI points.

To find out more about the mini-gastric bypass please contact Mr Awad’s team at info@sherifawad.co.uk
To calculate your BMI please go to: www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

Gastric Band (watch an animated video click here)

The gastric band is a surgical procedure performed using keyhole surgery under general anaesthetic as a daycase procedure (or overnight hospital stay). The operation is reversible and places a silicon based band around the upper stomach. This creates a small pouch which allows patients to feel fuller after eating a small meal and reduces the feeling of hunger between meals. The band is designed to help maintain long-term weight loss and should be viewed as a tool to aid weight loss. To achieve a good result from surgery patients will need to implement the appropriate dietary (correct food choices) and lifestyle (regular daily exercise) modifications, and attend regular follow-up appointments in order to achieve and sustain good long-term weight loss. Patients will need to attend clinic on a number of occasions for band fills/defills. On average patients can expect to lose 20% of their total body weight over a period of 12-18 months as the band is designed for slow continuous weight loss (1-2 pounds/week). Following surgery patients will need to take a daily multivitamin tablet.

To have a gastric band patients need to fulfil the following Body Mass Index (BMI) criteria:
BMI >30 in patients with diabetes, high blood pressure, hyperlipidaemia, sleep apnoea, polycystic ovaries syndrome (PCOS), fatty liver disease, joint/back pain/arthritis as a results of obesity
BMI >35 (Class II obesity)
In certain patient groups (asian, middle eastern, african, caribbean) the BMI thresholds for surgery are reduced by 2.5 BMI points.

To find out more about the gastric band please contact Mr Awad’s team at info@sherifawad.co.uk
To calculate your BMI please go to: www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

Gastric Balloon

The intra-gastric balloon is an endoscopic procedure (no surgery or scars) which is performed under throat spray or light sedation as a day case procedure (although some patients need an overnight hospital stay due to persistent nausea and vomiting). The balloon is inserted into stomach and removed after a period of six to twelve months. Its is designed as a tool to aid weight loss. To achieve a good result patients will need to implement the appropriate dietary (correct food choices) and lifestyle (regular daily exercise) modifications, and attend regular follow-up appointments in order to achieve good long-term weight loss. Patients will need to maintain these dietary and lifestyle modifications long-term in order to reduce weight regain after the balloon is removed. On average patients can expect to lose up to 5- 15kg in weight, mostly in the first three months, and then weight stabilises after this. This is only an average weight loss figure and some patients may not lose weight and others lose more these figures. Nausea and vomiting may commonly occur in the first 1-2 weeks after placement of the balloon as the stomach gets used to the balloon. Patients will need to be on a high dose antacid tablet to suppress acid production in the stomach for the duration the balloon is in the stomach (six or twelve months).

To have a gastric balloon patients need to have a Body Mass Index (BMI) >27.

To find out more about the gastric balloon please contact Mr Awad’s team at info@sherifawad.co.uk
To calculate your BMI please go to: www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

Weight loss surgery useful websites

International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO)
British Obesity & Metabolic Surgery Society
British Obesity Surgery Patients Association
Bariatric News
The East-Midlands Bariatric & Metabolic Institute (EMBMI) 

Information sheets for patients

Laparoscopic Cholecystectomy Information Sheet (LC1)
Laparoscopic Antireflux Surgery Information Sheet (LARS1)
Laparoscopic Incisional hernia Information Sheet (LAIH1)
Laparoscopic Paraoesophageal Hernia Repair Information Sheet (LPOH1)
Laparoscopic Gastrectomy Information Sheet (LG1)
Laparoscopic Oesophagogastrectomy Information Sheet (LOG1)
Bariatric and Metabolic Surgery Information Sheet (BMS1)
Intragastric Balloon Information Sheet (IGB1)

BOMSS Guidance for GPs Oct 14
BOMSS Nutritional Supplementation Guidelines Oct14
Edmonton Obesity Staging System
Liver Diet and Diabetes Meds
Postop Diet Gastric Band
Postop Diet Gastric Bypass
Postop Diet Sleeve Gastrectomy
Preop diet for Bariatrric surgery in Renal Patients
Preop Liver Shrinking Diet
Recognising Bariatric Complications
STOP-BANG EPWORTH QUESTIONNAIRE PP