Pre-selection
assessment
Criteria for ensuring suitability for
treatment:
- * BMI over 35 for Gastric bypass weight loss
- * BMI over 30 for Lap Band or Gastric Balloon
- * Aged 18 or over
- * The patient wants weight loss surgery after trying other
weight loss without success
- * There is no specific metabolic or psychological reason for
the obesity
- * The patient has sufficient understanding of the weight loss
surgery and the changes it
will produce
- * The patient is motivated to undergo the weight loss surgery
and post-op lifestyle changes
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Psychological assessment
The Clinical Psychologist may be asked by your
consultant to conduct a psychological evaluation prior to the
surgery to assess motivation and expected level of compliance. This
includes realistic expectations with respect to surgery,
psychological readiness, and ability to carry out required
post-operative lifestyle changes and acceptance of long-term
follow-up requirements.
Dietary advice –
monitoring
Each patient will be nutritionally assessed
pre and post bariatric procedure and provided with an
individualised dietary regime by a registered Dietitian, who
is part of the bariatric multidisciplinary team.
Diabetes and endocrinology
assessment
Many overweight people have unrecognised
diabetes. Unless this illness is managed effectively, long term
complications may develop. Careful assessment can determine the
presence of this, and other problems, before surgery is
undertaken.
Patients with previously diagnosed diabetes
require a thorough assessment of treatment particularly as this may
change significantly following bariatric surgery. It is also
necessary to review patients for both microvascular and macro
vascular complications of diabetes prior
to surgery.
Sleep analysis
Being seriously overweight carries a risk of
disordered breathing during sleep. Obstructive Sleep Apnoea
of great severity is common. Low Oxygen saturation during sleep
and abrupt changes in heart rate, together with frequently
raised arterial and pulmonary blood pressures are precursors to
Myocardial Infarction or heart failure. Preoperative
overnight investigation may be required depending on clinical needs
and treatment in the form of Positive Airway Pressure Therapy is
initiated and carried out as necessary.