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The department of diabetes, endocrinology and metabolism has been active in the field of obesity management and bariatric surgery for 30 years.
The regional service is provided jointly by Guy’s and St Thomas’ and King’s College Hospitals. Both offer full medical and surgical services for the treatment of young people and adults with obesity and medical services.
The Guy’s and St Thomas’ service is provided by a team based at Guy’s Hospital, including consultant physicians, liaison psychiatrists and psychologists, diabetes nurse specialists, and specialist bariatric dietitians. The service is in a dedicated environment with chairs and facilities suitable for patients with severe weight problems.
Guy’s and St Thomas’ obesity and bariatric service prepares around 150-200 patients a year for surgery and many more patients are helped to control their weight in other ways. Our surgical centre is located at King’s College Hospital and we have four bariatric surgeons.
The department has close links with local primary care organisations, charities with an interest in obesity disorders and patient groups.
Surgery for obesity and secondary metabolic disorders
The centre offers an introductory briefing to obesity, its complications and its potential management by bariatric interventions to all prospective patients. A comprehensive dietetic, medical and psychological assessment is performed prior to surgery in addition to assessment by a team of professionals from varying disciplines at the medical assessment.
The medical assessment includes 24-hour oximetry assessment for sleep apnoea and may involve referral to other departments such as cardiology, respiratory or renal medicine prior to surgery.
Patients may be approached to take part in research clinical trials for the treatment of obesity.
Once all required information has been gathered then a team meeting is held between the medical team and the surgical team to book individuals for surgical assessment and arrange for admission for surgery.
The centre is able to offer all major forms of bariatric intervention:
- gastric band implantation and adjustment
- sleeve gastrectomy
- gastric bypass surgery
- non-surgical interventions including endoscopic insertion of gastric balloons.
Patients are followed up after surgery by the surgical team and the original medical site dietitians and then by the surgical and medical teams. Patients continue to be assessed for two years post-bariatric surgery for medical and nutritional complications of surgery after which they are referred back to primary care.
- Dr Barbara McGowan, consultant in diabetes and endocrinology
- Dr Piya Sen Gupta, consultant in diabetes and endocrinology
- Kathryn Waller, bariatric dietitian
- Charlotte Birkett, bariatric dietitian
Ritchie Hooper, after surgery
Ritchie Hooper has lost nearly 10 since
he had bariatric surgery
Ritchie Hooper, 43, from Leybourne in Kent had bariatric surgery in January 2015.
Ritchie says: “At my heaviest I weighed 25.5 stone and had a 54 inch waist. Sometimes I wonder how I got in that position in the first place.
“In 2009, I was diagnosed with Type 2 diabetes and eventually I was put on insulin.
“The criteria for surgery are strict so it’s definitely not a temporary fix. You need to be in the right frame of mind before you go ahead with something so invasive.”
“I get lots of support from my specialist bariatric dietitian, and I also attend the bariatric surgery support group which meets once a month.
Ritchie Hooper, before surgery
Ritchie Hooper before surgery
“Since the surgery I’ve lost 9.5 stone, I’m down to a 36 inch waist and I have come off the insulin.
“Before I would always take the shortest route or get the bus. In the summer there was a rail strike. I decided to walk part of the way to work. I felt great and had the biggest smile on my face when I got there.”