The service provided by the RVI metabolic clinic is currently under review.

Patients wishing to undergo surgery for obesity must satisfy the following criteria

  1. Have a BMI greater than or equal to 40 kg/m2
  2. Have one or more medical conditions that are likely to show significant improvement through weight loss.
  3. Have no history of primary psychiatric disease and/or binge eating

These criteria are bases on national guidelines and have been agreed beetween Mr Peter Wright (Consultant Surgeon) and staff of the Metabolic Clinic.

If a patient satisfies the above criteria then the following steps are taken to assess the patient prior to surgery.

  1. Medical assessment to exclude secondary causes for obesity defines the medical problems that are likely to improve through significant weight loss, and to assess the patient's general fitness for anaesthesia.
  2. If the patient is a candidate for surgery then the case should be discussed with one of the Consultant Metabolic clinic staff to establish the case for surgery.
  3. Patient would then be referred to Dr Wilkinson for psychological assessment. All patients need to undergo this step although some patients can be assessed by clinical psychologists in other local districts if this is appropriate.
  4. If there is concern that a patient may have an underlying primary psychiatric condition that has not been previously defined then referral to the Department of Psychiatry would be appropriate.
  5. If psychological and psychiatric assessment confirms that the patient would be a suitable candidate, then referral should be made to Mr Wright to discuss surgical options.
  6. Once referred back to Mr Wright the patient does not usually need to come back to the Metabolic Clinic until surgery has taken place, although occasionally patients do need intermediate follow up for the management of other problems.
  7. Following surgery patients will be seen at Mr Wright's Outpatient Clinic or Surgical Assessment. They will also be sent a follow up appointment for the Metabolic Clinic for post surgery metabolic assessment and regular review of nutritional status. This will be conducted in conjunction with the Metabolic Clinic Dietitian and will include biochemical assessment of key nutrients including ferritin, folate and vitamin B12.