Overweight and obesity unit

The life expectancy of those suffering from obesity is reduced by an estimated 5–20 years, depending on the severity of the disease and the associated comorbidities. One of the main causes is our lifestyle. Low levels of physical activity together with a high-calorie diet rich in fats can lead to the development of obesity. However, obesity needs to be understood from a broader perspective than that which sees it as a low-grade inflammatory systemic disease. It is rather a multifactorial problem, in which different medical, psychological, social, nutritional and genetic factors are involved. That is why, the approach used must be individualised and multidisciplinary, and it must involve multiple specialists such as endocrinologists, nutritionists, surgeons, gastroenterologists, psychologists and personal trainers.

Our multidisciplinary team will guide you to help you achieve a healthy lifestyle and reach your goals:

Our team:

• General and digestive surgery
• Digestive endoscopy
• Endocrinology and Nutrition
• Psychologist
• Personal Trainer

MEDICAL TREATMENT

1^st. An endocrinology consultation: Study and assessment

Our Endocrinologist will carry out a personalised assessment of your body composition (weight, fat mass, height, basal metabolic rate, etc.) and based on this, she will identify and inform you of the most suitable treatment for you.   

It is important to determine your body mass index (BMI), which is calculated on the basis of your weight and height. BMI is one of the indicators of a person’s nutritional status, however, in order to determine whether a person is overweight or obese, it is also advisable to carry out other tests and obtain additional data.

Another important factor in determining whether you are overweight or obese is your body fat percentage. This measure will help us distinguish muscle mass from the fat in your body composition.

2^nd. Nutrition Consultation

Guiding, treating and teaching healthy habits to patients are some of our top priorities.

Our nutritionist will guide you throughout the process to help you achieve your goals. She will identify your nutritional mistakes and recommend the foods that are best suited to your circumstances.

3^rd. Pharmacological treatments

There are numerous pharmacological treatments that must be considered and which will be recommended in certain specific cases where their effectiveness and safety are justified.

Drug treatments should be used only under strict medical supervision.

GLP-1 analogues

These drugs cause a decrease in appetite and, together with a balanced diet and adequate physical activity, can contribute to a better control of body weight. According to the existing literature, an excess weight loss of 10% or greater can be obtained.

Its active ingredient acts on the brain areas that regulate appetite, making you feel less hungry and consequently decreasing your total daily calorie intake.

4^th. Additional treatments

4.1 Clinical Psychology Consultation: The Psychology of Obesity

As there are psychological variables associated with obesity, in addition to the treatment provided by our Endocrinology and Nutrition team, we also incorporate support sessions with our psychologist for an all-round treatment. There is a professional in our Unit who is qualified to carry out the necessary tests to detect such variables and implement the necessary treatment.

Our approach is to focus on the patients’ relationship with their own body: body image distortion, eating behaviour, self-esteem, personal relationships and lifestyle.

In addition, it is important to rule out other underlying potential conditions and to understand the role that obesity may play in each patient, whether as a consequence of personal situations or as the reason for other problems.

The psychologists and the rest of professionals that are part of our unit work together with the aim of improving motivation and offering psychoeducation, among other things.

4.2 Personal Trainer Consultation: Exercise and Obesity

Together with nutrition, physical activity is one of the key pillars in the treatment of obesity. The exercise professionals working at our unit can prescribe a tailored training program based on individual abilities and previous limitations. For this, our expert personal trainer must perform an initial assessment that will allow him to recommend the best type of training and duration of each exercise according to your specific needs.

 

OTHER TREATMENTS

Treatment with the Ingestible Elipse® Balloon

The Elipse® Balloon is a weight loss solution that does not require surgery, endoscopy or anaesthesia. Thanks to this method, food intake is reduced and patients can lose an average of 10-15 kilos in 16 weeks. The balloon works by taking up space in the stomach and inducing a feeling of fullness. It helps patients feel less hungry and, therefore, eat less at mealtimes.

The balloon is placed during a brief 20-30 minute visit to the doctor. The capsule that contains the balloon can be swallowed with a glass of water and then, with a quick X-ray the doctors will make sure that it is correctly positioned.

After 16 weeks, a time-activated release valve in the balloon will open, allowing it to empty and pass naturally through the gastrointestinal tract.

This treatment must be combined with a nutrition and exercise programme. A multidisciplinary team will assist and support you throughout the whole process to help you change your habits. You will maintain your weight loss and achieve your goals thanks to a healthier lifestyle.

If you are of legal age and have a body mass index of 27 or greater, this ingestible balloon may very well be the answer for you.

The treatment includes:

• Pre-procedure consultation with our surgeon
• Pre-procedure consultation with our endocrinologist
• Consultation with our nutrition specialist before the surgery
• Consultation with our clinical psychologist before the procedure
• Initial assessment by a personal trainer before the procedure
• Elipse® balloon implantation (performed by an expert digestive surgeon)
• Follow-up consultations with the digestive surgeon
• Follow-up consultations with our endocrinology department
• Follow-up consultations with nutrition specialists

 

ENDOSCOPIC TREATMENTS

1. ORBERA® Ballon

The ORBERA® intragastric balloon is a device designed to help you achieve a healthier lifestyle.

This device needs no surgery and you may lose 3.1 times more weight than what you would with diet and exercise alone.

Most of the weight is lost in the first three months, but because the gastric balloon will remain inside for longer, you will learn the right amount of food to eat to maintain your new weight.

If you are of legal age and have a body mass index of 27 or greater, you may be a good candidate for this treatment.

 

The treatment includes:

• Pre-procedure consultation with our surgeon
• Pre-procedure consultation with our endocrinologist
• Consultation with our nutrition specialist before the surgery
• Consultation with our clinical psychologist before the procedure
• Initial assessment by a personal trainer before the procedure
• Orbera® Balloon Procedure (performed by an experienced endoscopist)
• Follow-up consultations with the digestive surgeon
• Follow-up consultations with our endocrinology department
• Follow-up consultations with nutrition specialists
• Orbera® Balloon Removal Procedure (6 months to 1 year)

 

2. The Apollo® Method (Endoscopic sleeve gastroplasty)

Endoscopic suturing is a minimally invasive and non-surgical technique for treating obesity, with all the advantages it entails in terms of comfort, speed of recovery and reduced risks.

The reduction in stomach capacity acts on satiety levels, making the patient feel full with less food. In addition, the area of ​​the stomach where the hormone that controls appetite is produced is also reduced, making it much easier for patients to change their eating habits.

Compared to other endoscopic bariatric procedures, this endoscopic suturing system provides a greater reduction in stomach size, so that the stomach does not dilate over time. Weight loss after the procedure depends on each person, however, with this technique, between 50-60% of excess weight is usually lost.

A multidisciplinary team of professionals will assist and guide you throughout the whole process to help you achieve your goals.

The treatment includes:

• Pre-procedure consultation with our surgeon
• Pre-procedure consultation with our endocrinologist
• Consultation with our nutrition specialist before the surgery
• Consultation with our clinical psychologist before the procedure
• Initial assessment by a personal trainer before the procedure
• Apollo® procedure (performed by an experienced endoscopist)
• Follow-up consultations with the digestive surgeon
• Follow-up consultations with our endocrinology department
• Follow-up consultations with nutrition specialists

 

SURGICAL TREATMENTS:

Bariatric Surgery

If you are morbidly obese with a body mass index of 35 or 40 and you also suffer from other health problems such as diabetes or hypertension, following a specific eating plan and exercising may not be enough to reach your healthy weight. In this case, obesity surgery may very well be the best alternative. In some cases, bariatric surgery is the only remedy that has proven to be effective in reducing the morbidity and mortality associated with obesity in the long term.

Bariatric surgery is not just one type of surgical treatment. A specialist will assess your particular conditions and determine which of the available procedures is best suited to your case.

You will be assessed by our multidisciplinary team before the surgery so that they can draw up a diet and exercise plan for you to reduce the risks during the operation.

After surgery, and during your recovery time, our team will recommend certain guidelines (exercises, diet, medication, etc.), adapted to your circumstances. Our team will assist and support you throughout the process to ensure that you achieve your goals.

During the first four weeks, you will experience a significant weight loss. After that period, weight loss will slow down but you will still continue to lose weight progressively.

If your body mass index is over 40 kg/m² or even 35 Kg/m² and you also have other associated diseases such as diabetes and hypertension, this may be the best alternative for you.

Surgical techniques:

• Vertical gastrectomy
• Gastric bypass
• Duodenal switch
• SADI-S
• Other techniques

At the Overweight and Obesity Unit of Hospitales Universitarios San Roque, we have a large team of highly experienced professionals, and the latest surgical techniques available.

Obesity is a significant risk factor for other diseases such as diabetes, cardiovascular disease and cancer. Breast cancer, especially postmenopausal hormone receptor–positive breast cancer has been extensively linked to obesity.

One of the main causes is our lifestyle. Low levels of physical activity together with a high-calorie diet rich in fats can lead to the development of obesity. It is necessary to understand obesity from a broader perspective to include all the different medical, psychological, social, nutritional and genetic aspects that are involved. That is why HUSR takes a personalised and comprehensive approach to obesity providing a multidisciplinary vision that brings together all the necessary specialists, such as endocrinologists, nutrition experts, general and gastrointestinal surgeons, digestive specialists and psychologists, among others.

MEDICAL TREATMENT

1. Endocrinology Consultation

A personalised assessment of your body composition (weight, fat mass, height, basal metabolic rate, etc.) will be carried out and, based on this, a diagnosis will be made and the treatment to be followed will be determined. To find out whether you are overweight or obese, several tests are needed. For example, we will need to establish your body mass index (BMI), which is calculated using your weight and height, and your body fat percentage, which helps distinguish muscle mass from fat matter that is present in the composition of the body.

Pharmacological treatments: there are numerous pharmacological treatments that specialist must consider and which will only be recommended in certain specific cases where their effectiveness and safety are justified. Drug treatments should be used only under strict medical supervision. GPL-1 analogues: These drugs cause a decrease in appetite and, together with a balanced diet and adequate physical activity, can contribute to a better control of body weight. According to the existing literature, an excess weight loss of 10% or greater can be obtained.

Treatment with the Elipse® ingestible balloon: this is a weight loss solution that does not require surgery, endoscopy or anaesthesia. The capsule that contains the balloon can be swallowed with a glass of water and then, with a quick X-ray the doctors will make sure that the balloon is correctly positioned. Thanks to this method, food intake is reduced and patients can lose an average of 10-15 kilos in 16 weeks. The balloon works by taking up space in the stomach and inducing a feeling of satiety and reducing hunger, which leads to eating less food. After 16 weeks, a time-activated release valve in the balloon will open, allowing it to empty and pass naturally through the gastrointestinal tract.

1. Nutrition Consultation

Diet plays a key role in weight control and in preventing numerous diseases. The role of our nutrition service in this case includes a complete assessment of the patient’s nutritional status, dietary habits and lifestyle. In addition, it is also responsible for planning and creating meals or diets that are appropriate to each specific situation and according to personal characteristics or preferences. Our staff also plays an active role during all phases of treatment, helping answer any food-related questions to improve adherence to a healthy lifestyle and to achieve health goals.

1. Clinical Psychology - Obesity Psychology Consultation

Emotions play a crucial role in obesity as they produce physiological reactions in the body. Patients cope with these feelings by eating certain foods that generate “food addiction”, the so-called “comfort” foods (such as refined sugars and carbohydrates that produce pleasurable feelings by releasing serotonin, dopamine, opioids and endorphins in the brain, thus relieving negative emotional states). In these processes, the psychological approach is based on the detection, diagnosis and treatment of those psychological variables related to obesity (the patients’ relationship with their own body, body image distortion, their behaviour with food, their self-esteem, their personal relationships and their lifestyle)

 

ENDOSCOPIC TREATMENTS

1. ORBERA® Ballon

This device is designed to help you achieve a healthier lifestyle. No surgery is needed and patients can lose 3.1 times more weight than what they would with diet and exercise alone. Most of the weight is lost in the first three months, but because the gastric balloon remains inside for a few more months, patients learn the right amount of food to eat to maintain the new weight.

1. Apollo® Method (Endoscopic Gastric Sleeve)

Endoscopic suturing is a minimally invasive and non-surgical technique for treating obesity, with all the advantages it entails in terms of comfort, speed of recovery and reduced risks. The reduction in stomach capacity acts on satiety levels, making the patient feel full with less food. In addition, the area of ​​the stomach where the hormone that controls appetite is produced is also reduced, making it much easier to change eating habits. Weight loss after the procedure depends on each person, however, with this technique, between 50-60% of excess weight is usually lost.

 

SURGICAL PROCEDURES

Bariatric Surgery

The prevalence of morbid obesity has increased exponentially in recent years. Excess weight is associated with potentially serious comorbidities including type 2 diabetes mellitus (DM2), high blood pressure (HBP), respiratory, metabolic and joint pathologies, anxiety and depression, and it also increases the risk of cancer diseases.

 The candidates for obesity surgery are those with a Body Mass Index (BMI) above 35 kg/m2 with one or more severe obesity-related comorbidities.

Caring for morbidly obese patients requires a well-coordinated multidisciplinary team, including nutrition experts, anaesthesiologists, intensive care specialists, nurses, rehabilitation experts and physiotherapists, in addition to the bariatric surgery team and the endocrinologist, and the help of psychiatrists or psychologists, pulmonologists, cardiologists, plastic surgeons, radiologists and gastroenterologists. The whole team works together in four key stages: patient selection and assessment for bariatric surgery, patient preparation and optimisation for surgery, surgical intervention and perioperative care, and long-term follow-up.

 

Hospitales Universitarios San Roque is the leading private centre for bariatric surgery. Its technical and human resources and team of professionals are backed by extensive experience in the study and treatment of obesity. Each case will be assessed individually to determine the best treatment. Gastric bypass and vertical gastrectomy performed by laparoscopic approach provides excellent results.