Over the past year, an average of two people a week have gone under the knife in Swansea to treat obesity, which one surgeon has described as “the disease of the 21st century”. Bariatric surgeons like Jonathan Berry operated on 103 patients in 2022-2023: they removed part of their stomach so they couldn’t eat as much as before, they put a band around them so they didn’t have to eat as much to feel full. , or connect the upper part of the stomach to the small intestine so that they feel full more quickly and do not absorb as many calories from food.

A very small proportion of the 103 procedures carried out at Singleton and Morriston Hospitals involved post-surgical leaks or post-operative revision. The cost of treatment, including hospital treatment, was just over £867,000.

By comparison, Swansea Bay University Health Board operated on 25 obese patients last year, despite Covid causing significant disruption. In 2019-20, a year before the coronavirus outbreak, 59 obese patients underwent surgery. These health board figures were provided in response to a freedom of information request from the Local Democracy Reporting Service. For the latest health news, subscribe to our newsletter here

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Professor Barry said the operation was a success and the overall results were very good, although he said he did not perform any further gastric banding. “The next morning, patients feel fine: they wake up and their blood sugar is normal,” he said. After six weeks, he said, many were no longer taking their medications. “But they are not reversible operations, they are not done like that,” he said.

The NHS website lists a number of minor risks associated with weight loss surgery, including the need for vitamin and mineral supplements, excess skin folds and the development of a blood clot in the leg or lung. Professor Barry said he believes bariatric surgery is safer than gallbladder surgery, with the main risk being endoleak. He said patients undergoing surgery had to make lifestyle changes. After a while, many were referred to clinics specializing in weight control. “My role as a surgeon is a very small part of the process,” he said. Professor Barry acknowledged that around 10% of patients would regain weight, but said the results were generally good.

While the external signs of being overweight may be obvious, what happens inside the body is not. Professor Barry said there are 240 conditions associated with morbid obesity, including cardiovascular disease, depression, type 2 diabetes, hypertension, arthritis, obstructive sleep apnea and high blood pressure. “Type 2 disease is a brutal disease,” he said. “This constricts the small blood vessels and you can go blind, lose your legs and develop kidney disease.” And he added: “Some types of cancer become weapons of obesity.”

Professor Barry qualified as a surgeon in 1996 and operated on cancer patients before moving into bariatric surgery. The 52-year-old’s career has been linked to a rise in the proportion of overweight and obese people in Wales and elsewhere. A Welsh Government survey last year revealed that 62% of the Welsh population was overweight, including 25% of obese people.

“The numbers are staggering,” said Professor Barry, referring to the rates of obesity and type 2 diabetes. [obesity] disease of the 21st century,” he said. “Our genetic makeup hasn’t changed for thousands of years, but we live in a society that lends itself to obese people.” He attributed this to prepared foods that “were flavored with what you want to eat” but were nutritionally poor: just “empty calories.” He said back then there were larger portions, sedentary lifestyles, fewer sports at school and the fact that in the average family both parents tend to work today, which limited the time available to shop for and prepare healthy foods.

Professor Barry said: “Your genetic makeup loads the gun, but society pulls the trigger.” He explained that some people’s genes interfere with satiety and that it is surprising how much some obese patients eat. “They don’t have an off switch, but nobody wants a BMI (body mass index) of 50,” he said. “It’s not a way of life.”

Professor Barry, who lives in Cardiff, said he was concerned about the high rate of obesity among teenagers in Wales. “Bad eating habits do not go away on their own if they are instilled in childhood,” he said.

The NHS now offers a weight loss medicine called Wegovy, which is based on a type 2 diabetes medicine. It mimics the action of a gut hormone to help regulate food intake and appetite. Professor Barry said abdominal pain and diarrhea were side effects for some people taking it. While the drug is a useful tool in treating obesity, it does not address the root causes. Professor Barry said it all comes down to a “social problem” – the prevalence of certain types of food, the dominance of a small number of food companies, etc.

Talk of taxes and regulations has angered some people, and Professor Barry believes any regulations aimed at reducing junk food consumption should be taken seriously. However, there are many sources of information available about healthy eating, and Professor Barry’s experience with schools shows that they do a good job in this regard. Join our WhatsApp news community for the latest news

Next year, the Welsh Government will introduce new legislation to limit the advertising of foods high in fat, sugar or salt. It will not ban any specific foods and will not cover all foods high in fat, sugar and salt, but will focus on the foods and drinks most likely to contribute to obesity. Ministers said a survey carried out by Public Health Wales showed strong public support for government action to make our diets healthier.

Looking to the future, the consequences of diseases such as obesity and type 2 diabetes for the NHS and society as a whole look serious. In October this year, Dr Rob Orford, chief scientific adviser at Health Wales, published a 140-page report on the likely impact of long-term illnesses and risk factors in the coming years. According to him, prevention, support for people to change their lifestyle and early diagnosis are important.

Models cited in the report suggest the number of people with diabetes in Wales will increase by 260,000 by 2035-36, a 22% increase on current levels. Around 90% of cases diagnosed today are type two. Obesity rates are also expected to increase, but estimates vary by study. Professor Barry said: “A hundred years ago we didn’t have fast food. Basically, we eat a lot of rubbish.”