It is likely that you may have struggled to lose your excess weight for many years by other non-surgical methods and therefore may be a candidate for weight loss surgery. You may benefit from weight loss surgery if any of the following factors applies to you.

you are at least 100lbs overweight
if your body mass index (BMI) is between 35 and 40 with other associated health problems such as diabetes, high blood pressure (hypertension), arthritis in weight bearing joints, and acid reflux.
If your BMI is above 40.

You can calculate your BMI using our BMI calculator.

Do I need a referral from my GP?

Ideally we would request an initial referral from your general practitioner but you can also self refer by contacting us either by filling the enquiring form or by telephoning for an appointment on 0161 495 7000/1/2/3. When you self refer, we would like to write to your GP to keep him or her informed of your progress.

Which bariatric procedure will be suitable for me?

When you attend for your first consultation, Mr Agwunobi and his team will make a thorough assessment including your previous weight loss history and your general health and guide you to the most appropriate procedure for you as an individual. You will have plenty of time to ask questions regarding your concerns.

How is my weight loss surgery performed?

Mr Agwunobi performs all his weight loss surgery using modern keyhole (laparoscopic) techniques even in some patients who have had previous abdominal surgery. The keyhole approach results in less pain after surgery, quicker recovery and return to work. In addition there are less wound problems using the keyhole approach. It may be necessary in some patients to convert to open procedure but this happens very rarely.

How long is the hospital stay after surgery?

This will depend on the type of weight loss surgery (bariatric) procedure you have had. If you had laparoscopic gastric banding, you will be in hospital for one night. Laparoscopic Roux en Y gastric bypass and sleeve gastrectomy patients are usually in hospital for 2-3 nights with over 90% being discharged on the second day after surgery all being well.

What kind of diet will I have after my surgery?

Immediately after the operation there will be some swelling around the opening between the new small stomach and the intestine so initially only liquids can leave the pouch. There is also some swelling in the walls of the new stomach pouch, which contributes to a restriction of food and a feeling of fullness. During the first few weeks even a couple of teaspoons of food will make you feel full.

Following the operation you are advised to take liquids only. This will be necessary for at least 2 weeks. You will be started on sips of fluid and this will be increased to free fluids within a day or two. You will still only have room for a small amount of liquid at one time so drink slowly and take plenty of time between swallows.
Most patients are discharged from hospital after a couple of days so you will still be taking liquids when you first get home.

Try to have a variety of liquids to ensure an adequate intake of protein, vitamins and minerals. Do not have too much tea and coffee as these are not very nutritious, can cause constipation and reduce the absorption of essential nutrients. Avoid fizzy drinks for the first couple of weeks, as they will make you feel bloated unless they are flat. The consistency in these 2 weeks should be able to be taken through a straw.

For a more detailed information about dietary advice following weight loss surgery, please refer to the section "Dietary Guide following Weight Loss Surgery."

What should I do if I experience vomiting?

Eating too fast, too much, or food that is too solid may cause vomiting. If it contains pieces of food, you may not have pureed your food sufficiently. Sickness can also occur if you are not eating enough - if you starve yourself you burn off fat too fast and this causes chemicals called ketones to build up in your body and make you feel sick. Remember to eat small meals at regular intervals. If you are sick, return to soups and juices for a day and then restart pureed food. Make sure you keep taking your antacids medication such as lansoprazole FasTab but stop taking other supplements for a week. If it continues, stay on fluids and contact us, as you may need further assessment or a change in medication.

Do I have to have my gallbladder removed at the same time as my weight loss surgery procedure?

Although there is an increased risk of gallstones forming during periods of rapid weight loss, it is not always necessary to remove your gallbladder at the time of your weight loss surgery. If you already have gallstones at the time of your bariatric surgery, it may be necessary to remove the gallbladder at the same time as your weight loss surgery if they are causing you symptoms. Mr Agwunobi will discuss the options with you and come to an appropriate decision with you at the time of your consultation.

I have diabetes; should I continue to take my diabetes medicine?

It is not uncommon for patients with diabetes, particularly those who were taking tablets to be able to come off their medication and control their blood glucose by diet alone. This happens gradually as the extra weight comes off. It is important therefore for you to see your doctor and diabetic nurse regularly during the first 12-18 months after the operation to check your blood glucose. Your doctor will then decide whether the dose of your diabetes medicine should be reduced. This is important as your blood glucose may otherwise drop quite low, which can be dangerous.

How soon can I go back to work after my weight loss surgery?

Most people are able to return to work after 2-3 weeks following weight loss surgery.
How soon can I resume intercourse with my partner after weight loss surgery?
You may resume sexual intercourse as soon as you feel comfortable to do so.
How soon can I fly and go on holidays after weight loss surgery?
If you have flown into Manchester for your surgery, you may take a flight for your journey home. You may go on holiday 2-3 weeks after surgery as most people who have had the keyhole surgery have returned to their normal mobility at this stage.

How much weight loss will I achieve after my weight loss surgery?

This will depend on a number of factors including the type of weight loss surgery procedure, your individual circumstances and the level of commitments to the lifestyle changes required following weight loss surgery. Laparoscopic adjustable gastric banding generally offers 50-60% excess weight loss over 2year period while laparoscopic Roux-en-Y gastric bypass will offer between 60 - 75% excess weight loss mainly in the first 12 months.

Will I 'overshoot' and become too thin or will my body know when to stop losing weight?

This has not been a problem with patients. The operation has been designed to reduce the calorie intake to a level that is adequate to nourish the patient at their correct body weight. The weight will fall until this point is reached, and will then stabilise.
Very rarely do weight loss surgery procedures achieve 100% excess weight loss and this only happens in approximately 5% of gastric bypass patients.

Is it safe to become pregnant after weight loss surgery?

Yes, however we would strongly recommend you do not get pregnant until 12-18 months after your weight loss surgery while your body adjusts to the new changes. It is essential to use a reliable contraceptive method following weight loss surgery because the fertility of a woman tends to improve after she loses excess weight.

What medicines do I need to take after weight loss surgery?

You will need to commence on some daily supplements of multi-vitamins, iron supplements (especially in pre-menopausal women), calcium, vitamin D and 2-3monthly vitamin B12 injections for life following gastric bypass surgery. It is not essential to have these supplements following adjustable gastric banding but you will not be doing any harm if you take supplements following gastric band insertion.

Will I lose my hair following weight loss surgery?

During periods of rapid weight loss some people may notice a temporary thinning of their hair. This is especially so in the first 6 - 8months following gastric bypass surgery when the weight loss is most rapid. Zinc and selenium supplements as well as maintaining your protein intake will usually help. Our team will be able to help guide you on what to do if this happens. Your hair usually re-grows after the period of rapid weight loss.

What can I do if I develop excess skin following successful weight loss?

The amount of excess skin following successful weight loss depends on a number of factors such as initial amount of excess weight needed to be lost, amount of excess weight loss, age and skin conditions prior to surgery. About a third of people after weight loss surgery will have problems with excess skin. You may want to consider plastic surgery for the excess skin but we would advise you to wait until at least 18months after your surgery when your weight loss would have stabilised.

What is dumping syndrome?

Dumping syndrome occurs when there is rapid passage of food into the small bowel causing shift of fluid into the small bowel. There is also associated overproduction of insulin in response to this rapid food transit into the small bowel. If you eat a large quantity of sweet foods such as chocolate, the body responds by overproducing insulin which makes you feel light-headed, queasy and give you diarrhoea. You may also experience abdominal cramps. This is called Dumping syndrome. Many patients never experience dumping, but in those who do, they lose the sweet taste and craving, and this can be very valuable in helping to change old bad habits. In those who experience dumping syndrome this can be avoided by following the dietary advice in our "Dietary Guide Following Weight Loss Surgery."