The 'Knife Diet': anti-fat surgery booms

Increasing numbers of obese men and women are resorting to controversial weight-loss surgery despite growing concerns for its safety. New re-search shows that private clinics are reporting a 20 per cent rise in just one year in the number of stomach stapling and gastric bypass operations.

This trend, based on figures from Bupa, is confirmed by the National Institute for Clinical Excellence (Nice), which predicts the annual number of obesity operations performed on the NHS will rise from a current annual rate of 500 to 4,000 within eight years.

The demand for surgery in the UK echoes the situation in the US, where nearly 5 per cent of the population is considered morbidly obese. Over the past decade, the number of operations carried out in the US has escalated from 15,000 to 130,000.

So great is the demand for a surgical "fix" for excess weight that Britain's first obesity hospital opened its doors last month. The National Hospital for Obesity Surgery, a private clinic in Birmingham, will charge patients, who do not need a GP referral for an operation, upwards of £3,500 for treatments. These include the "balloon", where a sack filled with saline solution is inserted into the stomach to stem hunger pangs.

However, some experts are warning that surgery is not a solution in itself and also carries serious risks. As many as 2 per cent of patients die during or soon after surgery, according to research published by the New England Journal of Medicine. Cost is another factor. Each operation is performed at a current cost to the NHS of between £5,000 and £7,000, or more than £10,000 for a private patient.

Obesity surgery falls into two categories - gastric bypasses, where surgeons reduce the length of the digestive tract - and stomach stapling, a procedure to reduce the size of the stomach. These operations became available on the NHS in July 2002, but have been carried out in the private sector for the past two decades. Some private clinics are also offering to fit patients with a "gastric pacemaker", a device that uses electric shocks to stimulate the stomach, slowing down the movement of food through the intestine and making the patient feel fuller for longer.

Official estimates show that approximately one-quarter of adults and 15 per cent of all 15- to 16-year-olds in the UK are obese and 3 per cent are morbidly obese. About 30,000 people die each year in the UK as a result of problems associated with obesity, including heart disease, high blood pressure and diabetes.

Nine out of 10 patients are women who, having failed to reduce their weight through dieting and weight-loss clubs, turn to surgery to "cure" their excessive fat problems. But Kath Sharman, who works as a weight-management therapist in Sheffield, said the underlying factors of obesity are often anxiety and depression, which are not solved by an operation alone.

"If you give people an operation then the benefits will last for a short while but it doesn't take away the problem of using eating as a coping mechanism," Ms Sharman said. She added: "I think we could manage obesity a lot differently, with a programme of healthy eating and exercise. It is slower, but people want quick fixes."

However, Dr Ian Campbell, from the National Obesity Forum, which raises awareness of the impact of obesity, believes the NHS should provide more funding for these operations, otherwise people will borrow money for surgery and end up in debt. "The issue for me is not the cost of the surgery but the fact it should be more widely available on the NHS," he said.

Additional reporting by Frances Booth

THE NURSE'S STORY

Julie Maybin is a nurse practitioner at the National Hospital for Obesity Surgery in Bromsgrove, West Midlands, where she counsels patients preparing to undergo weight-reduction surgery.

It is a job for which she is well-qualified, personally and professionally. Two years ago, the 31-year-old was one of the first people in Britain to have keyhole surgery to reduce the size of her stomach.

Surgeons inserted a special "lap band" around her stomach wall which restricts the size of the muscle, allowing only a small amount of food to pass through.

Overweight since a child, Mrs Maybin (left, before operation, right, after) says surgery was a last resort after hypnotherapy sessions, special diets and years of attending weight-loss clubs all failed. At her heaviest, the 5ft 9in mother of two weighed nearly 22 stone. As high blood pressure runs in her family, this could have been fatal. Since the operation, Mrs Maybin has lost nearly seven stone.

"I'd tried Atkins, Weight Watchers - I'd been there and back with diets and bought the T-shirt," says Mrs Maybin, from Telford, Shropshire.

"I'm a terrible sweet-eater. Then after the birth of my children I'd gained so much weight."

At times, she would go all day without eating, but then feel so hungry that she would binge-eat.

"I was always the biggest in the family. I'm very happily married but I got into a comfort zone when I married. It was very much a case of sitting at home eating take-aways. I was morbidly obese and ended up being treated for depression."

Her dress size is now between 16 and 18, which means she has reached her goal of being able to shop in Next instead of in stores for outsize women.

"Over-eating is a disorder and there is no miracle cure," she explains.

"My job is not only to help people through the operation but also to help people to kick their habits and resolve issues with eating."