Bariatrics

  • Surgical services for the treatment of adults with obesity, aiming to improve health through weight management.

  • Address: Tunbridge Wells Hospital,

Get in touch

Consultant surgeons 

Bariatric anaesthetists

Endocrinologist

  • Dr Siva Sivappriyan

Bariatric clinical nurse specialist

  • Debbie Killick

Clinical psychologists

  • Dr Elaine Johnston
  • Dr Elizabeth Samuel
  • Dr Isabelle Philps

Bariatric dietitians

  • Samuel Thearson
  • Emily Eade
  • Kaego Okafor

Bariatric coordinator

  • Katherine Bedford

Bariatric navigator

  • Daisy Pearce

Tel 01892 635697

Email mtw-tr.bariatricservice@nhs.net

Dietitians

Our dietitians will assess you at our one-stop clinic and provide a nutritional plan.

We take into account your eating history, medical conditions, weight and activity level, biochemical markers and any current vitamin and mineral deficiencies.

We advise you on diet before and after surgery, and this will be personalised to your situation and the surgery you are planning to have or have already had. We will also talk about realistic weight loss outcomes and make sure you have all the information you need to make a decision about surgery.

You will get support you with diet, interpreting your blood tests and any changes to your bowels, taste, appetite or activity levels for two years after your surgery.

It’s important to commit to regular follow-ups for your safety and to ensure you are getting everything you need to have the best outcome from bariatric surgery.

Patient information library

 

Meet the team

 

Samuel Thearson, Specialist Bariatric Dietitian

Emily Eade, Specialist Bariatric Dietitian

Kaego Okafor, Specialist Bariatric Dietitian

Frequently asked questions

Can I use meal replacements for a liver reduction diet?

The dietetic team do not usually encourage using meal replacements as often they are expensive, and are packaged and branded in a way that might not make them suitable. If you want to use these products please ask for advice on appropriate products for you.

What if I am a vegetarian/vegan?

Vegetarian and vegan diets are increasingly common and the dietetic team are used to advising patients in bariatrics and in general practice. It is very important to stick to advice on nutritional supplements to ensure you have adequate iron and vitamin B12 – among others – that are often found in animal products.

I’ve done some reading and I’m worried about hair loss/dumping syndrome/I won’t lose weight/other

We encourage you to do research before you come to clinic. Peer support can be very useful but it is important to think about where you are getting information from and whether it is a reliable source. For example, NHS and surgery-specific groups are a much better source of information than social media.

If you are particularly concerned about issues such as hair loss or dumping syndrome, please discuss with the team at your one-stop assessment clinic

How much weight should I expect to lose?

Everyone is different and many factors play a part in how much weight people will lose. Usually we can expect people to lose between 50-70% of their excess weight after surgery, depending on their ability to exercise and how much they commit to making dietary and behaviour changes.

I have heard different things about having carbonated drinks or alcohol after surgery, what is the advice?

We advise people not to have alcohol for at least 6 months post-surgery, preferably one year. Due to your changed anatomy, you can become intoxicated a lot more quickly and need to consider your safety. Carbonated drinks can cause bloating and discomfort and there is some evidence that they stretch anatomy in the long term and making your restriction from bariatric surgery reduced.

What can I do while waiting for my appointment for assessment?

The best thing to do while waiting for your appointment is to try and continue weight loss (or at the very least remain stable).

  • Increase your activity and try to reduce portion sizes and snacking, if this applies to you.
  • Look at the information on this web page and watch the video.
  • When you are invited for a clinic appointment, attend a virtual education session and complete any questionnaires we send you promptly to avoid any delay.

Can I have my blood test on another day rather than at the one-stop clinic?  

Yes you can, if you live locally or are happy to travel prior to your appointment. Ideally, book to have bloods in the morning on a day before your first appointment.

How long will I stay in hospital?  

Most patients only stay for one night but this may need to be extended.

Will I be allowed visitors after my surgery?  

This will depend on the ward you are staying on. Most of our patients recover on the Short Stay Surgical Unit (SSSU) which unfortunately does not allow visitors due to its close proximity to the operating theatre and the risk of infection.

How long until I can drive after my surgery?  

Normally a minimum of two weeks depending how you feel following surgery, you may need longer.

How long until I can have a shower or bath after surgery?  

You can shower the day after surgery and can bath about two weeks after, as long as your wounds are clean and dry. We recommended this is a quick bath to prevent any wound infections.

Psychology service

The Bariatric Psychology service works alongside your dietitian, specialist nurse and surgical team to provide you with support in your weight-loss journey.

Bariatric surgery involves a permanent alteration to your body, as well as lifestyle changes before and after surgery, so it’s important that you are prepared, physically and emotionally.

If you are considering bariatric surgery, you will receive an appointment for a pre-surgery psychological assessment.

Who will carry out the psychological assessment?

You will be asked to complete a set of questionnaires before your appointment. These make up an important part of your assessment so if they are not completed and returned to us before your appointment we may need to rearrange your assessment until we receive them.

During your appointment you will meet with a clinical psychologist who is part of the bariatric surgery team.

What will happen at the psychology assessment appointment?

The appointment will usually last about an hour. The psychologist will ask questions about your reasons for surgery, your view of your current body shape, your understanding of the surgery and its side-effects, and motivation to make the necessary lifestyle changes required.

We will also ask you about your psychological wellbeing and any specific eating-related difficulties such as emotional eating or eating disorders.

Can I bring someone with me to my psychology assessment?

Many patients like to bring someone with them to their bariatric surgery assessment appointment either for support or to help with practical arrangements such as parking.

The assessment is a one to one appointment with you, and often patients prefer to see the psychologist on their own as they may not wish to share all of the information discussed with someone else.

You are welcome to bring the person accompanying you to your appointment if you wish.

What happens after surgery?

The Bariatric Psychology service, along with the dietitians and nurses offer post-operation support sessions which you are welcome to attend.

These take place online and usually include a talk and time for discussion, meeting and sharing information with other service users and asking any questions.

There will be ups and downs as part of a person’s weight-loss journey. These sessions are an important tool, providing support to help you get the best outcome from your surgery.

The bariatric psychology service does not offer one-to-one psychological support but if you think you would benefit from additional psychological input before or after your surgery, we can signpost or refer you to an appropriate service. 

We always recommend that you discuss any changes to your emotional wellbeing or health with your GP who can also refer you to appropriate support.

Meet the team

  • Dr Elaine Johnston, Consultant Clinical Psychologist
  • Dr Elizabeth Samuel, Clinical Psychologist
  • Dr Isabelle Philps, Clinical Psychologist.

Support

 

Urgent mental health support

For urgent help and support, call NHS 111, or the Kent and Medway Mental Health Trust Single Point of Access free 24-hour helpline on 0800 783 9111.

Those with a hearing impairment should call 0786 002 2819.

  • Mental Health Matters is a confidential service run by trained staff which you can call any time, any day. Call  0800 107 0160  or email info@mhm.org.uk
  • The Samaritans are available 24 hours a day, 365 days a year.
  • Safe Havens is a walk-in service (no need for referral) offering welcoming, non-clinical, non-judgemental, safe environments across Kent
  • If you are feeling low or struggling to cope and need urgent mental health support, you can text a trained Shout volunteer at Shout.

 

Psychological support

You can self-refer or ask your GP or any healthcare professional to refer you for NHS talking therapy.

 

Alcohol and smoking 

 

Practical support

  • Live Well Kent provides support from healthy living, to accessing counselling, managing your money and making new friends
  • Kent Together can help make sure you have enough food and supplies, pick up prescriptions, (except in Tunbridge Wells), and make sure you have someone to talk to
  • Porchlight help people manage any issues affecting their day-to-day life and their ability to live independently
  • Red Zebra is a provides services across Kent enabling people to be involved and active in their communities
  • MoneyHelper offers free and impartial money advice
  • StepChangeoffers tailored advice and practical solutions such as bankruptcy advice and debt management plans
  • Kent Karrier will take you from your home to set locations, such as the nearest town centre or supermarket. 
  • Carers Support provides family carers with information and support
  • Crossroads Care provide services to allow family carers to maintain a life of their own outside their caring roles.

Clinical nurse specialists

Clinical nurse specialists (CNS) will support you through online education sessions before your one-stop appointment, which will give you an overview of the service, what will be required from you, and what you can expect from our team.

At the one-stop clinic bloods will be taken before your appointment, on the same day. The CNS will take an ECG (heart reading) for your anaesthetist to review, and discuss surgery and care during and after your hospital stay.

Following the clinic, they will support the surgical team to make a decision about your procedure.

After your surgery the CNS will review you on the ward before you are discharged and talk to you about what you’ll need to do over the next few days, including your medications, wound care, mobility and pain.

As a part of your follow-up the CNS will contact you a few days after you leave hospital to advise on your care and wellbeing, and answer any questions. They will be involved at key points throughout the two years of your follow up either individually or with colleagues. They are also available in between if you need guidance and support to help you get the best outcome from your surgery.