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Surgeons on TV

Filming the ward

Bariatric News talks to Peter Small, a bariatric surgeon featured on a new TV documentary observing the staff and patients in a busy UK bariatric centre.

Peter Small and Terry Gardner on Weight Loss Ward

Weight Loss Ward, currently being broadcast on ITV in the UK, tells the story of a bariatric ward in the City Hospital in Sunderland, in the north east of England.

The show is a slice of life for the staff of the ward and their patients: doctors and nurses beg their patients to stick to their diet and do their exercise, and patients dutifully agree, before crawling towards a healthy weight pound by painful pound, or guiltily slipping back into old habits. Successes are hard fought for, and failure comes all too easily. If you’re a bariatric surgeon, it all might seem awfully familiar.

“Surgery works. It's the only way we've got of getting weight down, but it's not the answer. What we really want is for the country to change.” Peter Small

“I thought that it might be a good idea to get a warts and all picture of the NHS put out there,” says Peter Small, a bariatric surgeon at City Hospital, who features in the documentary. “All the programmes you’ve been seeing up to now have been about super-sized mums and super-sized sons and what have you, usually arriving from America. This is not about sensationalising patients or going for the shock and awe stories.”

The first episode concentrates on a small group of patients, including Terry Gardner, a 47-stone man who is so obese that Small can’t risk giving him a gastric bypass; Erica Barber, who shuts herself in her house and eats her way through a shopping trolley worth of treats every weekend; and 19 year-old Sophie Lang, who wants a gastric balloon, despite her young age.

Small says that the experience of filming the show helped him in the treatment of the patients: seeing footage of their home life revealed aspects of their life that allowed him to see whether they were really ready for surgery. “We were getting information coming back from ITV which had been hidden from us,” he says. “Using our weight-loss plan to see if they could alter their lifestyle, she cheated. She simply cut out her insulin - she peed out her fluids. Of course her weight went down.”

Terry Gardner, in his home. Before getting treatment, he rarely left his front room and could barely fit into his bathroom.

He says that the experience reinforced his belief that surgeons need an understanding of the patient’s mindset, and a demonstration of their desire to lose weight, to establish whether they’re ready for surgery. “There’s quite a lot of surgeons who will say there’s no point in pre-operative weight loss targets,” he says. “They say it’s not going to make the surgery that much easier; all you’re doing is punishing the patient. Well, you’re not – you’re getting their mind fixed to the idea that they have to make changes first. Surgery will help them, but it won’t do it for them.

“If you operate on somebody without them appreciating that, you will find a number of them will try to continue their old habits. If you do a bypass you will, for a period, restrict their dietary intake. But if they work at it, they can get the calories in. A year or two down the line, they’re back to where they were.”

There are some failures on the show – a psychologist decides that Erica is not psychologically ready for an operation, and Sophie fails to lose weight after her balloon is inserted. There are some successes as well, though – Deborah Adams, who was largely confined to her house after a period of precipitous weight gain, was able to return her wheelchair after her comorbidities were resolved. Terry Gardner lost three stones on his gastric balloon, putting him closer to the point where a more invasive operation is feasible. A local boxing club, having heard his story, has offered to help get him active with an exercise regime.

Unfortunately, but unsurprisingly, the reaction from many on the internet was not so positive: many used Twitter to express their anger and disdain for those on the show. “Weight Loss Ward is making me feel sick,” says one; “Get up and exercise and stop eating crap! No sympathy!” says another.

“You’re going to get very mixed reactions,” says Small. “But I find that fascinating. We know that 60% of this country are either overweight or obese. Almost two in three of the people who are slinging this mud have to do something about their own weight. And they’re not picking that one up. They’re not appreciating that.”

Small says that if there’s a message that he wants people to take from the show, it’s that “surgery works.”

“It’s the only way we’ve got of getting weight down, but it’s not the answer,” he says. “What we really want is for the country to change. You can’t sit down and eat what you want, not exercise, and expect to be thin.That’s what I hope we get across.”

“Whether that happens is another matter.”

The first episode of Weight Loss Ward is currently available online on ITV Player. The second, and final, episode will be played this Wednesday at 8pm on ITV1.