The Bariatric Consultancy Education and Training Programme

The Bariatric Consultancy (TBC) has an education and training programme that has been developed over four years of research. It has been developed to provide an education and training resource for other healthcare professionals who wish to gain insight into obesity and the issues faced when working with the overweight patient. The programme has been delivered over the past four years to healthcare professionals in Tiers 1, 2 and 4.

The Bariatric Consultancy Ltd (TBC) is a recognised provider of training in obesity and weight management. They have successfully delivered training to a diverse mix of practitioners including:

Eastern Coastal Kent Cardiac Rehabilitation Team
NHS Kent & Medway Primary Care Nurses and Diabetes Teams
NHS Kent & Medway Exercise Referral Team and Exercise Outreach Workers
NHS Kent & Medway Primary Care Teams
St Richard’s Hospital Trust Bariatric Nursing Team
St Richard’s Hospital Trust Occupational Therapy Team
St Richard’s Hospital Trust General Practitioner Training
University of Chichester Sport Psychology Department
University of Chichester Humanistic Counselling Department
NHS Sussex Primary Care Teams
NHS Sussex Health and Well-being Tier 2 teams
NHS Kent & Medway Single Patient Funding Panel for Morbid Obesity
Trainees from the Institute for the Arts in Therapy and Education
Trainees from Sussex University Counselling Department

TBC have also provided ongoing advice and information on obesity and the development of treatment pathways to a number of commissioners and consulted on service development.
TBC have an extensive programme of training that has a core of information that is developed according to local need taking into account the need for cultural diversity in the education provided.

Conference Presentations

2009 International Federation For The Surgery Of Obesity And Metabolic Disorders (IFSO)
“Poor Psychological Health in Bariatric Surgery Candidates”

2009 British Psychological Society Eating Disorder Chapter
“Obesity and Disordered Eating”

2012 British Psychological Society Sports Psychology Chapter
“Psychopathology of Obesity and Working with the Overweight Patient”


Education and Training Programme

TBC are committed to the continuing research of obesity and its treatment.
TBC have the following training programme which will be implemented across Kent:

TBC have also presented parts of these modules at seminars in the UK and Europe. TBC was the first UK contributor chosen to present a psychological research abstract at an International Federation of Surgery for Obesity (IFSO) conference. This research focused on the poor psychological health of Bariatric surgery candidates in the UK and was presented in Paris in 2009.

TBC have co authored three research papers:
1. Poor Psychological Health in Bariatric Surgery Candidates
2. Constructing a Psychologically Led Tier 3 Service for Adults Presenting with Complex Obesity
3. Developing A Psychologically Led Tier 3 Obesity Service As Part Of An Integrated Obesity Management Model

Training Programme

TBC has developed the following training modules; these are presented in Power Point format and have supporting manuals and literature.

Content

This two-day workshop aims to provide an overview of some of the complex issues underpinning obesity and the psychological impact it has on people’s emotional well-being. Participants will be provided with tools to help them assess correct treatment pathways for individuals. They will also be introduced to some Cognitive Behavioural Therapy tools for use within their own practice.

Topics covered will include:
• Background to obesity, the facts and an overview of the obeseogenic society
• The many meanings of food in modern society
• Cultural and family issues around food
• The aetiology of disordered eating
• Prejudice and discrimination of the overweight patient
• Poor mental health and the correlation with obesity
• Psychological disturbance and weight gain
• Emotional eating and food addiction
• Treatment pathways and the use of Cognitive Behavioural Therapy (CBT)
• Assessment tools to determine treatment pathways
• CBT tools for treatment
• ‘Cost benefit ‘ analysis is the patient ready for change?
• The cycle of change and the cycle of emotional eating
• Dealing with difficult emotions, finding an emotional language
• Building self esteem and turning thoughts from negative to positive
• Understanding thinking styles
• Goal setting and dealing with setbacks
• Planning for the future
• Affirmations

A Primary Care Intervention for Overweight Patients

• Background to CBT
• The general principles of CBT
• The thoughts, feeling, behavior link
• CBT tools for treatment
• Assessment for treatment
• ‘Cost benefit ‘ analysis is the patient ready for change?
• The cycle of change and the cycle of emotional eating
• Dealing with difficult emotions, finding an emotional language
• ‘Big I, Little I’ Building self esteem and turning thoughts from negative to positive
• Understanding thinking styles
• Goal setting and dealing with setbacks
• Planning for the future
• Affirmations
A one-day workshop for healthcare professionals in Tiers 1,2

• Historical overview of Bariatric surgery procedures
• NICE guidelines for surgery
• An overview of obesity management models Tiers 1,2,3
• Tier 4 multi-disciplinary management
• Overview of main four procedures, Gastric Band, Gastric Bypass, Sleeve Gastroectomy, Inter-gastric Balloon
• Short film clips of Band and Bypass procedures
• Problems including weight regain (Swedish Obesity Study)
• Medical problems and long term issues
• Band or Bypass patient suitability criteria
• Multi-disciplinary assessment pre surgery
• Pre-surgery ‘milk’ diet
• Patient pathway on Tier 4

Management in the community; problems to look for including;
• Excessive weight loss
• Band problems and band sabotage
• Psychological disturbance including developing eating disorders
• Addiction transfer
• Dealing with excess skin and skin folds
• The reality of corrective surgery
• Long term weight maintenance and healthy lifestyles
A half-day workshop for healthcare professionals

• NICE guidelines for obesity management
• Overview of Tier 1,2 and 4
• Tier 3 specialist management
• Patient pathway
• Patient assessment
• Multi-disciplinary team and treatment options
• Psychological management
• Group work or one to one sessions
• Understanding emotional eating
• Dietetic support the key objectives
• Exercise and activity and motivating patients to change
• Pathway to Tier 4
• Long term patient management in primary care
Warts and All’, Dispelling the Myths Around Weight Loss Surgery
A presentation for all patients requesting referral to Tier 4

• NICE guidelines for surgical treatment
• The PCT pathway
• The reality of surgical weight loss and when it goes wrong
• Weight regain (Swedish Obesity Study)
• Mortality rates for surgery
• Long term health problems
• Understanding surgical procedures the four main surgery types
• Which procedure is right for which patient?
• Assessment criteria for Bands and Bypass
• Pre surgical ‘Milk” diet
• Tier 4 treatment and hospital stay
• Post surgery eating; restrictions and problems
• ‘Dumping’ syndrome and band sabotage
• Band problems including slippage and erosion
• Psychological problems including relationship problems and addiction transfer
• Problems of excess skin and skin folds
• The reality of corrective surgery
• Short film of Band and bypass procedures