Treatment pathway

What should I expect on my journey to weight loss surgery?

Anybody is welcome to attend a free consultation run by our specialist nurse. She has specialist training with expertise in obesity and is sensitive to the specific needs of patients who are overweight. Here you will spend about an hour discussing the pros and cons of weight loss surgery and the various treatment options in your individual case. We ask a series of questions to assess both surgical and alternative treatment options and help you to fully understand the risks, benefits and challenges of successful weight loss for the long-term.

Alternatively, for the standard surgeon consultation fee, you can book in directly for an appointment with one of our surgeons, although we do suggest you see our specialist nurse with a free consultation first. To meet directly with a surgeon it is preferable, but not absolutely necessary, to obtain a referral from your GP, as this gives details about your current and past health, along with useful information such as your medication, allergies and so on. We do feel that it is important for your GP to be involved at this point, if they haven't been already. Your GP needs to be aware that you are considering surgery as they will be an important source of support to you once it's done, and they will continue to monitor your improving health as the weight comes off. Our surgeons will write back to you and your GP after the consultation.

During your first appointments, the benefits and risk of surgery to help you manage your weight will be explained carefully and any questions that you might have will be answered. At the end of these consultations, you should have a clear idea of the different weight loss surgical procedures available, which one is best for you and why, what the procedure involves, and what to expect afterwards. If you are still keen to go ahead with surgery, the next step is usually to have a consultation with our dietitian and one of our psychologists. These will be separate appointments made on other days, and they take about an hour each. These are important parts of our assessment of your suitability and the chance of doing well after weight loss surgery. We hold a multi-disciplinary meeting every month where we discuss all our patients considering surgery, and ensure that the team is happy with the plans around going forward to surgery.

In some cases, the initial consultations with a specialist nurse or surgeon will identify aspects of your health that makes weight loss surgery more risky, and perhaps not appropriate to be undertaken in the private sector in Edinburgh. In this case, the next person you would see is one of our anaesthetists. This would also be at a separate appointment. If they are happy with the possibility of surgery in your case, then you would proceed to appointments to see our dietitian and one of our psychologists.

Sometimes, we may need you to be seen by a variety of other specialist doctors, such as if you have complicated other co-existing illnesses that require careful consideration prior to surgery. These are for your safety and best outcome, and often incur a consultation fee payable to the doctor who sees you about these, unless you are able to have this consultation within the NHS. This is quite possible if you are undergoing regular care by a specialist in the NHS, as we can write to them and ask their advice.

Once the team are happy that weight loss surgery is appropriate for you, our secretary will offer you some date options. The Spire Murrayfield Hospital will confirm the inclusive care price specific for you to help you make your final decision.

Once you have been accepted for surgery, and are keen to go ahead with surgery, doing everything you can to be as fit and healthy as you can be is an important step. Sometimes, the team will set targets for you to meet that makes your operation safer for you and appropriate for the Spire Murrayfield Hospital. We are here to help you meet those targets, such as some weight loss, or improvement in diabetes control. You may wish to have a further consultation with our specialist nurse or surgeons to answer any further questions and this is easily arranged if you request it. Sometimes, we will ask to see you back to discuss any issues that we have about you undergoing weight loss surgery, so that we can involve you in the decisions.

Once you are booked for surgery, the Spire Murrayfield Hospital pre-assessment team may have a video conference or a face to face consultation with you. Sometimes, this identifies other health issues which may require you to see an anaesthetist at this stage. But quite often, the anaesthetist will see you for the first time on the day of surgery, although they are involved with the MDT meeting, and also have access to your Spire medical records prior to your day of admission.
Two weeks prior to surgery you start the special pre-operative diet. This is a very low calorie diet leading up to the day of surgery. This is important to help you lose a bit more weight, and in particular improve the state of your liver. May people who are overweight have a ‘fatty liver’, which both gets in the way of the operation, and is easily injured.

On the day of surgery you will be admitted to the hospital about 2-4 hours before the due time of the operation, and settled in to the ward by the Spire Murrayfield Hospital staff. Both the surgeon and the anaesthetist will visit you and check that you're ready and consented for the operation.

You will be taken to the operating department where our team will help you feel as relaxed and comfortable as possible. When you wake up the operation will be all over. You will be in the recovery area for a little while, before being taken back to the ward. Depending on which procedure you've had, within a few hours you'll be wide awake and able to sit up, talk, and have a drink.

The aftercare depends on which procedure you have had but in every case you will receive all the help, advice and support that you need. The fee for the operation includes all aftercare for 12 months relating to your surgery, including any visits with the nurses, dietitian, surgeons or radiologists that may be required. It is not routine for you to see a psychologist after your surgery, but this can be arranged as necessary, although there may well be a charge for consultations with a psychologist if you need more than one post-operative review.

After the 12 month follow up period is over, we strongly encourage you to keep in touch with your GP for ongoing follow-up and nutritional monitoring. You can continue to see our team if you wish, although there are charges for these consultations.

Our whole aim is to support your physical, social and emotional well-being so that you feel better, are more confident, more relaxed, and ultimately have a longer, happier and healthier life.