The University’s BHF Glasgow Cardiovascular Research Centre has received £2.1m from the National Institute of Health Research (NIHR) Health Technology Assessment programme to study the clinical outcomes of bariatric surgery conducted in Scotland over more than a decade.
Bariatric surgery is a set of procedures involving stomach surgery designed to help obese patients lose weight by either restricting the physical size of their stomach or allowing less food to be absorbed. The surgery can take the form of gastric banding, gastric bypass surgery or sleeve gastrectomy.
Currently, around 500 bariatric procedures are carried out across the NHS and private health services in Scotland each year.
However, while evidence has shown that the surgery can help patients to achieve significant weight loss and reduce the incidence of illnesses such as diabetes in the short term, there is a lack of up-to-date research on the long-term outcomes for those who undergo the procedure.
Dr Jennifer Logue, Clinical Lecturer in Metabolic Medicine at the University of Glasgow, who will be leading the research, said: “This will be one of the largest and most in depth studies of the effects of bariatric surgery and we’re confident our results will have relevance to healthcare professionals across the world.
“We’ll be collecting data from all NHS and private sector surgeons performing bariatric procedures in Scotland and we’ll be building an innovative IT-based clinical information system to help us keep track of at least 2,000 patients who have had surgery and agreed to participate in the study. We’ll recruit them over a five-year period and follow up on their health following their surgery for an average of 10 years after that, as well as looking at death rates of participants and their cause of death.
“One of the key factors which makes this study possible in Scotland is the excellent existing IT infrastructure which links across the NHS and will allow us to build an effective and economical clinical information system.”
The study will track patients’ experience of complications after surgery and the incidence of obesity-related physical illness such as diabetes and cardiovascular disease, as well as monitoring the rate of potential complications including nutritional deficiencies and fractures. Patients will continue their normal face-to-face checkups but the clinical information system will also automatically track each of their contacts with the NHS, allowing researchers regular updates with minimal inconvenience for patients.
Patients will also be asked to self-report for mental health issues such as anxiety and depression as well as answering questions on their perception of their own quality of life.
Dr Logue added: “Although the overall study is long-term, the way our information-gathering will work will help us to produce numerous shorter-term reports, such as the reporting of complications experienced at the time of surgery.
“These results will help strengthen the existing guidelines on bariatric procedures on an ongoing basis and allow us to look at which patient groups are responding best to the surgery and which are most likely to suffer complications.
“We expect that the outcomes of the study will have a major impact on international understanding of the risks and benefits of bariatric surgery.”
The funding for the project will begin in January 2012 with 18 months of development of the underlying data collection methods then gradual recruitment of surgeons and patients. Full recruitment will begin in January 2014, continuing up until January 2019, when the project will switch purely to patient follow up before coming to a close in July 2026.
Michael Donohue case study
Michael Donohue, an Edinburgh social care worker, had a sleeve gastrectomy procedure in August 2009.
At his heaviest, Michael weighed around 32st and suffered from numerous health problems including diabetes, sciatica, high blood pressure and high cholesterol. Today, he weighs around 14st.
Michael, 47, said: “Being overweight had a huge impact on me, both physically and psychologically. As a social care worker, I found it hard to do my job to the best of my ability. I found it hard to help move patients and even getting around myself was increasingly difficult.
“Outside of work, I was becoming reclusive. My self-esteem was very low and I would stay home as much as I could. Sometimes I even found myself wishing I could just go to sleep and never wake up again. I was caught in a vicious circle where I would eat to make myself feel better and then gain more weight.
“I’ve dieted all my life but after losing weight I’d always end up putting more back on. When I heard that bariatric surgery procedures were available on the NHS I thought it might be my last chance to lose weight. I spoke to my GP and spent a lot of time consulting with dieticians, psychologists and surgeons before the procedure.
“After the surgery, I had a lot of psychological support from NHS services. I’d spent my life using food as a coping mechanism and I was no longer physically able to do that. Being able to talk to mental health professionals and learn other ways to cope with the triggers which would lead me to overeat has been crucial to helping me succeed.
“It was hard going physically for a while, too. I made a mistake a short while after surgery where I tried to eat a small slice of ham and it caused me terrible pain. It took six months or so before I could go back to anything like a normal diet. I’ve also been left with a lot of loose skin after losing so much weight.
“Even with the effects of the surgery, though, I’m so much happier and more self-confident now. All the medical problems I suffered from have either lessened or gone altogether. I spend a lot of time in the gym and I really feel like I’m a new person.”
For more information contact Ross Barker in the University of Glasgow Media Relations Office on 0141 330 8593 or email firstname.lastname@example.org