What happens after I have been referred?

First appointment

On arrival at the clinic, a nurse will take some measurements including your weight, height, neck circumference and blood pressure. You will also fill in an eating habits questionnaire which will be discussed at your next appointment.

You will then be seen by a doctor who will take a full medical history, finding out about your general health and eating habits. The person seeing you will answer any remaining queries which you may have following group education. They will also offer you some guidance over which procedure may suit you the best.

At this stage you will be referred to other members of the multi-disciplinary team for detailed assessments and treatments to maximise your health before surgery e.g. respiratory physicians, psychiatrist, cardiologist and endocrinologist. Who you get referred to really depends on your individual situation.

If you don’t attend you rappointments, you may be discharged back to your GP to avoid disappointing other patients who would like to avail the opportunity.

Pre-surgery review appointment

This appointment will be carried out by one of the surgical doctors. The doctor will see you with reports of all tests and reviews – if you have engaged with the instructions given in the first appointment and your tests do not show any reasons to avoid surgery, the surgeon will offer to put you on the waiting list for the operation. The purpose of this appointment is to check out progress on the following:

  • Funding status
  • Reports back from other referrals
  • Check weight is not increasing.

If everything is in place, the surgeon will place you on the waiting list.
 
If you don’t attend your appointments, you may be discharged back to your GP to avoid disappointing other patients who would like to avail the opportunity.

Other Appointments

If you don’t attend for you appointments, you may be discharged back to your GP to avoid disappointing other patients who would like to avail the opportunity.

Group Education

You will receive a letter inviting you to Group Education on two occasions.

These are 1-2 hour group sessions attended by approximately 12 patients held in the Whittington Education Centre (WEC) behind the Jenner Building or in the N19 meeting room (at the back of the canteen).

The sessions are supported by a PowerPoint presentation and our aim is that people leave with a good understanding of the operations we offer, the benefits and risks, the implications on your life and diet and our pathway leading up to surgery.

There is also ample time allotted for questions.

You cannot progress to the next stage of the assessment without attending Group Education.

Psychology/Eating disorder appointment

After you have been assessed in full, the team may wish to refer you to a psychiatrist for assessment and treatment of:
• Disordered eating habits, which may prevent you from reaching your full weight loss potential.
• Depression – which may be linked to comfort eating.
• Psychiatric illness for which you may need support prior to being able to undergo surgery.

You will be seen by a psychiatrist at the Whittington Hospital or at the Eating Disorders Unit at St Ann’s Hospital in Tottenham.

Other specialist appointments to assess fitness

Some patients are at a higher risk of developing complications during or after surgery due to pre-existing illness. You may be referred to:

Respiratory physicians for:
  • Sleep studies – if you are at risk of obstructive sleep apnoea
  • Respiratory function – if you have breathing difficulty from lung diseases
  • Smoking cessation clinic for smokers

ECHO, ECG, exercise bike test
If you are at risk or have a history of heart problems.

Endoscopy
If you have a history of significant acid reflux or any other symptoms without a known cause

High Risk Anaesthesia Clinic
You may be sent to see an anaesthetist to assess your fitness for an anaesthetic.
 

Physiotherapy led Exercise

Some patients who have been found to be high risk due to their cardiac status may be asked to attend an exercise programme. This is usually for 6 weeks and your fitness levels and cardiac function will usually be measured before and after to observe improvements.
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