5 June 2019

A Telford man has thanked staff at the Royal Shrewsbury Hospital (RSH) for saving his life after he lost over half his body weight with the help of the Bariatric team.

Jason Parrish, 45, had struggled with his weight from an early age, and by the time he was 40 he tipped the scales at 40 stone. After being referred by his GP to the Bariatric Service at RSH, he dieted and undertook extensive health education before having a gastric balloon inserted, followed by a sleeve gastrectomy.

In the space of two years Jason has overcome a catalogue of health issues and lost a staggering 23 stone to reach his target weight of 17 stone. Please see the attached case study for his full story.

Bariatric Surgery covers a number of procedures used to help people who are very obese to achieve and maintain long term weight loss. It is offered to patients, following a referral from their GP, who have a Body Mass Index (BMI) over 40 or a BMI over 35 with weight related health problems such as Type 2 Diabetes, sleep apnoea, high blood pressure and hip and knee arthritis. Many of them have spent a lifetime dieting without success.

The Shrewsbury and Telford Hospital NHS Trust (SaTH), which runs RSH and the Princess Royal Hospital (PRH) in Telford, is an advocate of exercise and healthy eating, but for some people who reach a certain weight this is no longer enough.

Sister Bryony Price, Senior Bariatric Nurse at SaTH, said: “We often joke to one another that we’re addicted to chocolate or that we can’t live without cheese, but an addiction to eating is very real.

“Everywhere we go we are offered extra shots in our latte, there are supersize meals on menus, biscuits with 20% extra free, and shops selling meal deals that encourage us to eat more. It is so easy for people in today’s environment to get fat.

“It’s understandable to think that people should be able to exercise self-control, but if you consider morbid obesity as an illness, we are now dealing with an epidemic that has taken hold over the last 30 years and, unlike some other habits, we can’t distance ourselves from it to break the cycle. We are surrounded by food and food messaging every single day.”

Some feel that Bariatric surgery is expensive and wastes time and money when the NHS could be helping patients with other illnesses, but Sister Price explains that it can save the health economy money in the long-run: “Our hospitals are full of patients with Type 2 Diabetes, and currently 90% of these patients are overweight or obese.

“It is estimated that the NHS spends £22,000 every minute treating diabetes, so the cost of Bariatric surgery can be offset within three years as patients no longer need expensive diabetic medications.”

Approximately 180 obese people are having safe and effective weight loss surgery at RSH every year, and the team’s relationship with the patients doesn’t end once surgery is over. At SaTH a big emphasis is placed on high quality aftercare that helps patients through the important first few years after the operation, when the effects of surgery plateau and they need to maintain their own weight loss.

Mr Manel Riera, Consultant Bariatric Surgeon, said: “Bariatric surgery is a safe, cost-effective therapy for obesity, a deadly disease. Over 30% of people in the West Midlands are obese, with many of them morbidly obese and suffering from diabetes, sleep apnoea syndrome and a host of other medical problems. While significant resources are spent on prevention of obesity, patients with morbid obesity and other diseases will benefit from the support of our specialist team.

“The Bariatric unit here in Shropshire provides a holistic approach, based on the individual needs of our patients. The guidance provided throughout their long journey, both before and after the surgery, will help them achieve long term maintained weight loss and very significant health benefits.”

Sister Price and her team run a patient support group that meets bi-monthly in the evenings at PRH and RSH. Patients thinking about surgery and those who have been through surgery meet to share experiences, listen to speakers and swap tips on how to make the process a success. The group is also an invaluable source of support so that patients can see that they are not on their own.

For more information about the Patient Support Groups contact Sister Price via email: bryony.price@nhs.net

Jason’s Story

Bariatric Surgery – Jason Parrish, 45 years old from Telford

I was born weighing 11lb 4oz and used to joke that arriving into the world at that size I had no chance of ever being slim.  I was overweight throughout my childhood, and by the age of 13 I weighed 13 stone.

As a child I was diagnosed as dyslexic and was bullied for that as well as for my size. My eating became pernicious; the more I was attacked by my schoolmates, the more alone I felt and the more I sought solace in food. I would steal bread from the cupboards at home and stick my finger in the butter at my grandmother’s house. Things became so bad at school that eventually the teacher let me leave class five minutes before the bell went each day so I could get a head start away from the bullies.

I left school at 16 to train as a gamekeeper. Because I was active it was easy to tell myself that I was fit and didn’t have a problem. I did lose a few stone, but the weight loss plateaued after a while, and by the age of 21 it had crept up to 21 stone. By this time I was eating four boiled eggs on four pieces of bread and butter for breakfast, fish and chips for lunch, a full roast for dinner and countless chocolate bars and packets of crisps in between. Most days I would get through a loaf of bread.

Things got worse for me when my mum bought a pub and I stopped working as a gamekeeper to run the kitchen for her. From then on, I was around food all the time. I wasn’t consciously eating big meals, but I would try everything I cooked, and I would eat all the leftovers. If I wasn’t in the kitchen cooking, I was in the pub drinking. Guinness was my drink of choice and in one night alone I drank 23 pints.

By the age of 30 I weighed 30 stone. There was tremendous pressure on my joints, and I was in constant discomfort. I developed a terrible pain in my side at one point that became so unbearable I went to A&E where I was diagnosed with acute appendicitis and rushed straight into theatre. Three hours later I was wheeled out, still with my appendix intact. Because of my size, the doctors were unable to intubate me. I was treated with antibiotics and told that if the appendicitis returned it could kill me as I was too big to operate on.

Rather than giving me the reality check I needed, after that my weight sky-rocketed. Any remaining self-worth I had disappeared. The more I weighed the less I could do, and I became trapped in a vicious circle. I was still occasionally working, ironically in catering, but I was now unable to fit in my car and became, essentially, a recluse for 10 years. Despite everything, it still didn’t sink in that anything was wrong, that I might have an addiction. It was just what my life had become. Furniture at home broke, floorboards creaked when I walked on them, and I had to have the bath taken out – I was told that the combination of my size and the weight of the water in the tub would eventually cause the ceiling to cave in.

Later that year, after a fall at home, with my blood pressure sky-high, and suffering from pre-diabetes and sleep apnoea, I went to my local GP and was seen by a locum, who brought up Bariatric surgery for the first time. I went away saying I would consider it but I still didn’t know if it was something that could help me – I was so far beyond the point of thinking I could ever lose weight.

My breaking point came when my seven-year-old grandson asked me out of the blue later that week if I would be at his wedding when he was grown up. I just burst into tears. I thought ‘No, I’m going to be dead’. It was at that moment I accepted that I had an addiction and had to make a change. I was eating myself to death.

The Bariatric department at the Royal Shrewsbury Hospital changed my life. At my first appointment in January 2017, my consultant, Mr Riera, told me that I tipped the scales at 39st 13lbs – a quarter of a tonne, with a BMI of 79.7. I hadn’t been able to weigh myself for 10 years and I felt disgusted that I had allowed things to get that bad. After a few more meetings, it was agreed that I was a good candidate for bariatric surgery. I was to have a gastric balloon for six months, where a silicone balloon is placed and inflated in the stomach with about 700ml of fluid to promote a feeling of fullness, and then a sleeve gastrectomy, where most of the stomach is removed, leaving a sleeve-shaped cylinder of stomach with reduced capacity.

Before any of this could happen though, I had to lose five percent of my bodyweight, and was sent home with an initial four stone weight-loss target. I left the hospital thinking there was no way I would manage it, but after four months, I had lost five stone. I also attended teaching sessions which discussed every aspect of my potential journey from dietary advice to behaviour changes. With hindsight this part of the treatment was as important as the surgery itself as it made me examine my relationship with food, and taught me that I could lose weight on my own.

As my weight-loss journey progressed I realised that as well as being addicted to food, for me the act of putting my hands to my mouth was a compulsion. I taught myself to make knotted keyrings and bracelets to break the habit. I would walk, in the dead of night so no one could see me, to the end of our street and back. It’s only 150 yards and would take me 20 minutes, but it meant I was out of the house, moving and not eating.

For the fortnight before both surgeries I was on an 800 calorie day per day diet, which was difficult but manageable as for the first time in my life I had a goal, and something to strive for.

My life has changed unimaginably in the 12 months since my bariatric surgery. I have lost 23 stone and reached my target weight of 17st. My clothes size has gone from a 7XL to an XL. My blood pressure is normal, I am no longer pre-diabetic and my sleep apnoea has gone. I eat a healthy diet; a slice of wholemeal toast for breakfast, a sandwich or soup for lunch and some meat or fish with a salad for dinner, but I don’t deny myself anything. I will have a piece of chocolate or the occasional bacon sandwich, but it will be one, not four or five. I live with some side effects of my weight loss, including excess skin, but with hold-in clothes, I am beginning to feel more confident about my body.

I’m in control of my eating now, and I’m in control of my life. I can do the things that many people take for granted. For the first time ever I attended my grandchildren’s sports day last summer, and in September I travelled down to London on the train – two decades after I last managed to fit on one of the seats. I’m still nervous to exercise in public, but I wrote to a local farmer who lets me use his land, so I walk four miles every day. Later this year I plan on trekking up Mount Snowdon.

This is the start of my journey, and I need to maintain this weight loss for the rest of my life. After a couple of years the effects of gastric sleeve surgery slow down dramatically and then it will all be down to me. The fact I managed to lose five stone myself gives me the confidence to know that I can do it on my own again, but I have an addiction and I live with the demons every day. I will never not have to work at keeping my weight down.

Patients who think surgery is a short cut that will do all the hard work for them will fail. Bariatric surgery isn’t an easy way out, it’s a tool to kick-start a healthier life, and I thank the staff at the Shrewsbury and Telford Hospital NHS Trust every day, because without them I would be dead. They are heroes to me. The support they gave, and still give me, has empowered me and given me my life back. I’m a real person again, not a pariah. Now when my grandson asks if I will attend his wedding when he’s grown up, I can say yes, I’ll be standing proudly at the front watching you.