‘Fat doctor’ is patients’ last resort
 LEE WEST was so fed up with evening meals of sandwiches, crisps, fruit and yoghurt during a recent stay in hospital, he picked up a phone and ordered a takeaway pizza. It was duly delivered to his ward – right up to his bed, in fact. Staff had told him meal choices were out of their hands and down to the food supplier. Lee, 35, from stoke-on-Trent said, “The staff were absolutely fabulous, but the food wasn’t.”
ALTHOUGH he is hesitant to use the words “last resort”. Surgeon Guy Slater knows that’s what he is for patients who come through his door, writes Bill Gibb. There really isn’t a next step for the often morbidly-obese individuals referred to him. If he can’t use his skills to perform crucial surgical techniques, their lives will, at best, continue in the same restricted fashion.
At worst, their weight will kill them. Now, the remarkable specialist obesity surgery work of Guy and colleague Shaw Somers is the focus of an news TV series, Fat Doctor. “We’re definitely seeing more referrals than ever.” Says Guy who, with Shaw, runs Streamline Surgical, as well as carrying out NHS work at St Richard’s Hospital in Chichester.
WEIGHT PROBLEMS
“The patients we see have found that diets and the available drugs haven’t worked, and there really isn’t anywhere else left to try. “Quite often, they have diabetes or heart disease because of their weight problems and frankly, their lives are pretty awful. “They can’t work, they’re often housebound, and almost any exercise drains them. “We routinely see patients at 20 and 30 stone and have even worked with those who are 45 and 50 stone. “In fact, we’re currently assessing one patient who’s 60 stone.”
There are two basic options for those referred, each generally carried out as a key hole procedure. One is the fitting of a gastric band around the top of the stomach. It leaves a little pouch, carefully calibrated, to ensure that patients feel fuller with smaller portions of food and don’t have the desire to snack in between meals. The more invasive and aggressive approach involves a bypass, during which not only is the top of the stomach actually stapled to leave a smaller pouch for food, but the small intestine is also cut and directly attached to the pouch.
Risking their lives every day
It more forcibly restricts calorie intake, as well as affecting a hormone change that also leaves patients wanting less to eat. “Both procedures have their risks which we make patients very aware of,” adds Guy. “With the bands, those risks are very small – perhaps one in 1000, which makes it less risky than, say, a gall-bladder operation. “While the bypass risk may be about one in 500, in bigger patients with heart disease, for instance, it can be one in 50 or indeed less. “But some of the patients we see are so big and in such a bad way, they’re risking their lives every day. “They know that if nothing is done, the chances are they’ll die within a year or two. “And they often say that they just can’t bear to live as they are any longer. “The satisfaction comes when you see them a year or two later at a follow-up clinic session, and you simply don’t recognize them because they’ve lost so much weight.”
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