Bariatric surgery
Contact
- Outpatients appointments
- 020 3313 5000
Visitor Information
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We are currently unable to offer patients GLP-1 agonist treatment for obesity, despite NICE appproval - find out moreUnfortunately, all referrals wil be rejected. There are ongoing conversations across North West Integrated Care Board to discuss commissioning of this new service. If our ability to offer these changes in the future we will update this information on our website. All GLP-1 agonists for obesity treatment are currently not available. |
Our weight loss (bariatric) service based at St Mary’s Hospital in London, is known as the Imperial weight centre.
We provide a comprehensive surgical and medical service for patients from across the UK who are overweight, have medical problems and need to lose weight to improve their health. Our primary objective is to make our patients healthy.
We assess all our patients for illnesses caused by obesity so we are able to identify and are fully aware of any potential risks that may arise during treatment. These include diabetes, obstructive sleep apnoea (OSA), high blood pressure, polycystic ovarian syndrome and heart and lung conditions brought on by the physiological stresses of obesity.
We encourage a holistic approach to weight loss and as one of the largest NHS trusts in England, our bariatrics team can call upon a wide range of resources and expertise from across our hospitals to help benefit our patients.
Conditions and treatments
We provide weight loss surgery (bariatric surgery), a surgical procedure that only requires a small incision for the surgeon to access the inside of the abdomen and pelvis using an instrument called a laparoscope. It is also known as keyhole surgery. The types of weight loss surgery we offer include:
- Gastric bypass – this procedure connects the small intestine to a small pouch created from the upper part of the stomach making the stomach smaller, reducing the amount of food that can be consumed and bypassing the first part of the intestines to limit the amount of nutrients that can be absorbed.
- Sleeve gastrectomy – this involves stapling the stomach. Unlike a gastric bypass, the route that food is the same as before surgery but the stomach has been made smaller. It holds less and stretches more quickly, giving a feeling of fullness.
- Gastric band – in this procedure an inflatable band (the gastric band) is inserted to sit around the top of the stomach. The stomach can then be narrowed by inflating the band, leading to a feeling of fullness by limiting the stomach's capacity to take food.
All surgical choices are made based on the patient's medical comorbidity and suitability. Our patients are discussed in our regular multidisciplinary team meetings, allowing the whole team to have a complete understanding of each patient’s situation before any treatment decisions are made. Our experience has shown that this approach leads to a significantly better outcome for our patients.
All patients are offered surgery specifically tailored to their individual needs. Patients also have the opportunity to meet previous patients that have been treated and operated on in our bariatric unit.
Our surgeons’ experience and skill in these operations mean all our gastric banding operations are treated as day case procedures and patients who have a gastric bypass or sleeve gastrectomy can expect to stay in hospital for just one or two nights.
Bariatric surgery has been shown to have a beneficial effect on other health problems in patients who are morbidly obese:
- Half of patients with acid reflux will no longer require treatment after having bariatric surgery
- Forty percent of patients with joint pain and osteoarthritis experience an improvement in their symptoms after having bariatric surgery
- Forty percent of patients with urinary incontinence experience an improvement in their symptoms after having bariatric surgery
The Imperial weight centre is one of very few centres accredited as an international centre of excellence (ICE) for bariatric surgery, and was the first in the UK to be awarded this accreditation.
The Trust also provides a Tier 3 weight loss management programme in line with NICE guidance for patients considering surgery who have not undergone a medically supervised weight lost programme in the community.
Clinics
Bariatric surgery clinics
Our bariatric surgery service offers two clinics at St Mary's Hospital: One for new patients who are referred for surgery, and another for patients who are referred to us having had a previous bariatric surgery. Appointments are held at the main outpatients on the second floor at St Mary's Hospital, which can be accessed via Winsland Street.
Address
Surgical Outpatients
2nd Floor, Main Outpatients Building
St Mary's Hospital
Winsland Street
London W2 1NY
Phone: 020 3312 2300
Email: imperial.sicreception@nhs.net
Contact information
Tier 3 bariatric admin team
Phone: 020 3312 6561
Email: imperial.Tier3.Weight@nhs.net
Tier 4 and Tier 5 bariatric admin team
Phone: 020 3312 6449
Email: imperial.bariatrics@nhs.net
Bariatric psychology team
Phone: 0203 312 6449
Email: imperial.bariatric.psych@nhs.net
Bariatric dieticians team
Email: imperial.bariatric.dietitians@nhs.net
Bariatric surgery nurses emergences
Phone: 07826859741
For all appointment rescheduling or cancellation please contact these numbers above.
Meet the team
Consultant bariatric surgeon and lead surgeon
Consultant bariatric surgeons
Mr Sheriff Hakky
Mr Krishna Moorthy
Mr Sanjay Purkayastha
Mr Christos Tsironis
Ms Patricia Ortega
Consultant anaesthetist
Dr Jonathan Cousins, bariatric clinical service lead
Consultant endocrinologist
Dr Harvinder Chahal
Dr Alex Miras
Dr Saira Hameed
Dr Chioma Izzi-Engbeaya
Professor Tricia Tan
Consultant psychiatrist
Clinical psychologists
Dr Lucy Tweedle
Clinical nurse specialists
Louisa Brolly
Karen O’Donnell
Ciara Price
Dieticians
Candace Bovill-Taylor
Joanne Boyle
Jessica Upton
Kate Parry
Patient information
Before your appointment
Patients will be offered an appointment date within four weeks of our booking centre receiving the referral. You are welcome to bring a relative, close friend or carer with you to your appointment.
Please bring your appointment letter, a list of your medications and, if you like, a list of questions to discuss with your consultant.
During your appointment
When you arrive at the clinic please check in either at the reception desk or use one of the self-check-in kiosks.
We aim to see you at the time stated in your appointment letter however please be aware clinics can run late due to unforeseen circumstances. We will try to notify you when clinics are delayed.
Please note that we are a teaching hospital, so medical students may be present for some appointments. If you do not wish to have them in the room please let the nurse or doctor know and the students will be asked to step outside.
Your first appointment is a group meeting. At this appointment you will receive detailed information on the bariatric service offered from members of the clinical team. This appointment will last for three and a half hours.Please note that if you have not attended the group meeting you cannot be considered for further treatment.
If you elect to follow the surgical pathway following the first clinic appointment, your next visit will consist of two appointments on the same day – one to see the surgeon and one to see the anaesthetist. During these appointments the surgical team will discuss the types of surgery you are considering and assess your suitability. The surgeon will discuss the risks and benefits of surgery and if you decide you would like to proceed you will be asked to sign a consent form at this appointment.
In a series of appointments you will also see the anaesthetist, psychologists or psychiatrists, a nurse and the dietician.
After your appointment
If further appointments are required you will be informed of this after the consultation and a follow-up appointment will be booked. If you require further investigations the results will be discussed with you at your next follow-up appointment.
Following surgery you will have regular scheduled follow-up appointments with our specialist nurses and dieticians. It is imperative that you maintain your post-operative appointments as it is not uncommon for patients following surgery to become deficient in essential vitamins and minerals.
Before surgery
The Bariatric dietitians provide support and guidance during your pre-operative and post-operative surgical journey. Patients that have completed the Tier 3 weight management program at the imperial weight centre or an equivalent program elsewhere in the UK, whom are suitable for surgical intervention will see the bariatric dietitians as part of the Tier 4 bariatric service.
Once you have been given a date for your surgery the bariatric dietitians will meet with you in a virtual group setting to discuss the pre-operative diet which all of our patients are asked to strictly follow in the weeks leading up to surgery. This diet is often known as the liver shrinkage diet and the aim of this diet is to reduce the glycogen stores in the body especially those in the liver. This results in the liver ‘shrinking’ in size making it easier to move to safely perform bariatric surgery.
One to one appointments are offered to those requiring additional support, for example individuals requiring interpreters or those who have been asked to follow the diet for longer than 2 weeks.
Post-operatively, the bariatric dietitians will provide support and guidance around the types of foods and fluids you will need to choose in the first 12 weeks after surgery. This includes a staged build-up of different textures from liquid, pureed, soft and back to normal healthy eating. You will receive two routine follow up appointments with the bariatric dietitians for the first 2 years post-operatively to support long term healthy eating and sustainable weight loss.
Throughout your surgical journey you will have access to our dietetic team, who can offer tailored advice and answer any questions or concerns you may have around nutrition and diet.
Please see below useful websites
- Weight Loss Surgery Info
- NHS choices weight loss surgery
- Recipes for life before and after bariatric surgery - bariatric cookery book from NDR UK £6.50
- Bariatric cookery
Dietary protocol for bariatric surgery
Please note that the pre-operative diet should be followed in the two weeks immediately before the surgery only. Some individuals will be asked to follow the diet for longer, but this will be a modified form of the diet and you will need to speak with the dietitian for further help with this on 020 3312 5688.
Watch the video to find out more about the pre-operative stage of the diet.
Weight management and bariatric dietitians
About our service
The dietetic team at Imperial Weight Centre are here to provide help and support to people who are trying to reduce their weight with surgery with the support of our Tier 4 Bariatric Surgery service.
Service changes
As of September 19 2024, we are no longer able to offer our Tier 3 Dietitian-led 8-week Specialist Weight Management Programme. This decision has been made due to the high demand on our service and changes in our commissioning. Currently, we are only commissioned to provide bariatric surgery for the management of obesity.
NICE guideline - Quality statement 5: Referring adults for bariatric surgery assessment | Obesity: clinical assessment and management | Quality standards | NICE
Medication provision
Unfortunately, we are unable to provide GLP-1 medications, including Saxenda or Wegovy, through the Imperial Weight Management Centre, as these treatments are not commissioned within our current service scope. However, we are actively working with the North West Integrated Care Board to establish a new multidisciplinary service to support these interventions. We will keep GPs and patients informed as we develop this pathway and establish the capacity to deliver these treatments.
Additional Information on GLP-1 Medications:
- Ozempic (semaglutide 1mg) is not licensed for weight loss in the UK on an NHS prescription.
- Mounjaro (Tirzepatide) is currently under review by NICE as a potential treatment for obesity in adults.
At this time, we are not maintaining a waiting list for GLP-1 medications.
Next steps for patients
You may have been contacted to determine whether you would like to be considered for bariatric surgery. If you choose to explore this treatment option, we will arrange for you to be booked into our surgical clinic. If you decide not to pursue this option, you will be discharged back to your care.
Future updates
Should our service receive commissioning approval for GLP-1 medications, we will update the relevant information on our Trust website and send further notifications to GPs.
Please see below some useful websites
NHS Choices Weight Loss Plan
Headspace – Mindful Eating
Healthy Food Guide UK - healthy recipes and monthly meal plans.
Diabetes UK
Change for Life - healthy recipes, meal ideas and shopping tips
BDA lets get cooking
Refer to this service
GP
Please use NHS e-Referrals to refer a patient to our bariatric surgery service.
How to find us on ERS
Speciality GI and Liver (Medicine and Surgery)
Clinic Type Upper GI incl Dyspepsia
Service Endocrinology|Tier3 Weight Management Programme TRIAGE| St Mary’s| Imperial NHS Trust |RYJ
Please note that all NHS patients must be referred by a GP. All new patients referred for obesity management are initially seen at one of our group seminars, which is run weekly.
Conditions treated
Obesity, Type 2 diabetes. NHS England requires that all individuals have attended and complied with a local Tier 3 WMP for a minimum of 6 months before referral to Tier 4 services for surgical assessment to ensure:
- All other non-surgical options have been exhausted;
- the patient has demonstrated a commitment to lifestyle changes required for a successful outcome from surgery;
- patient is fit for surgery.
Any patient identified as clinically inappropriate for Tier 3 WMP i.e. the presence of serious uncontrolled disease, may be considered by the MDT for direct referral to our Tier 4 bariatric services for assessment and advice.
All patients referred for consideration for Tier 3 WMP must meet the NICE guidance for bariatric surgery:
- BMI of >35, in the presence of diabetes and/or other significant co-morbid conditions (high blood pressure, PCOS and infertility, OSA) that could be improved if the patient lost weight
- BMI >40 without the presence of diabetes and/or other significant co-morbid conditions
An expedited assessment for bariatric surgery will be offered to people with a BMI of 35 or over who have recent-onset type 2 diabetes as long as they are also receiving or will receive assessment in our Tier 3 service.
An expedited assessment for bariatric surgery will be offered to people of Asian family origin with a BMI of 30–34.9 who have recent-onset type 2 diabetes as long as they are also receiving or will receive assessment in our tier 3 service. Patients with a BMI >50 may also be considered for expedited assessment.
Please read exclusion criteria before referring patient to WMP
Does the patient appear to eating difficulties to the degree of an eating disorder? If so, our service is unable to offer specialised treatment for eating disorders in-house. Please consider onwards referral to the patient’s local eating disorder service for assessment and potential treatment, prior to WMP referral.
Does the patient have active risk concerns that require assessment and/or risk stabilisation? If so, such concerns are likely to act as a barrier to your patient’s ability to engage in our weight management program. We are also unable to offer a crisis mental health service. Please consider onwards referral to the patient’s local mental health Single Point of Access (SPA) for assessment and risk stabilisation, prior to WMP referral.
Does the patient have severe and/or enduring mental health difficulties that are not assessed or managed (e.g. active and unmanaged psychosis symptoms)? If so, if so, such concerns are likely to act as a barrier to your patient’s ability to engage in our weight management program. Please consider onwards referral to the patient’s local mental health Single Point of Access (SPA) for assessment and possible treatment, prior to WMP referral.
Patients under the age of 18
GP advice
Phone: 0203 311 5000
For advice regarding non-surgical weight management, please contact Sahra Jama, Tier 3 bariatric co-ordinator on 020 3312 6561 or email IMPERIAL.TIER3.WEIGHT@NHS.NET.
For advice about referrals to our bariatrics service, please contact Debbie O’ Rourke, our Tier 4 bariatric coordinator, on 020 3312 6449 or email IMPERIAL.BARIATRICS@NHS.NET.
Your inpatient stay Your stay in hospital
You may need to stay at one of our hospitals to have a procedure or receive treatment, either overnight as an inpatient or during the day as a day patient. Ahead of your inpatient stay, you will usually need to attend a pre-operative assessment appointment.
Find out more about how you can reschedule or cancel your inpatient stay, pre-operative assessments, what to bring with you when you come to hospital and much more.