The Superman surgeon and his one-man fight against the flab

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It is early Friday morning on the day surgery ward at Heartlands, Birmingham, the fourth biggest NHS hospital in the UK. Kim Beedie, 50, is one of five patients (the youngest is a 17-year-old girl) waiting to be operated on by Paul Super, Britain's busiest gastric band surgeon.

Mr Super fits an average of 20 patients with the weight-loss implant each week in his NHS and private practices - most of his contemporaries manage just ten.

'My NHS commitment is 50 hours a week, which leaves 118 hours in which I can take on private work,' he says, not entirely seriously.

In total, Mr Super has carried out more than 2,400 of these operations since 2001. And he still manages to spend a weekend once a month in A&E 'up to my elbows '.

'I recently worked out that if each of my patients so far lost five stone - most of them will do and more - it would add up to about 75 tons,' says the 47-year-old Scotsman. 'That's the weight of seven double-decker buses.'

The gastric band was invented by Swedish surgeons in the mid-Eighties, and last year about 5,000 UK patients underwent the (that's about 25 a day) - 2,724 of them paid for by the NHS - making it the most common bariatric (weight-loss) operation.

As an upper gastro-intestinal specialist, Mr Super is one of 40 or so surgeons in the UK licensed to carry out this kind of procedure and estimates he will perform operations on more than 1,000 obese men and women this year.

'He's the man when it comes to gastric bands, or so I've been told,' says Kim, rather proudly.

At 20 stone and 5ft 4in tall, she is classed as super-obese with a body mass index (BMI) of 50. In a few minutes, she will be wheeled into an operating theatre and anaesthetised before undergoing a life-changing 30-minute keyhole operation.

Mr Super will attach an inflatable silicon gastric band, about 1 Once in place it will remain there permanently, restricting the amount she can eat in one sitting to little more than a few spoonfuls.

Women such as Kim make up 80 per cent of gastric band patients, despite the equal sex distribution of obesity. Private companies have reported a 500 per cent increase in operations in the past two years, no doubt bolstered by the 'Fern effect' when This Morning presenter Fern Britton controversially admitted in 2007 that her dramatic weight loss was the result of a gastric band.

'Perhaps it is more socially acceptable for women to seek help for their weight,' says Mr Super. 'Or perhaps it's more socially acceptable for a man to be overweight.'

His is perhaps a unique perspective on our national weight problem - we are the fattest country in Europe, with one in four adults classified as clinically obese.

'I don't know what is big any more,' says Mr Super, who lives in Hampton-in-Arden, Solihull, with his wife Helen, also 47, a primary school teacher, and their four children, Jessica, 21, Daniel, 18, Rosie, 16, and Jonathan, 14.

Despite his skills, Mr Super is the antithesis of a flash surgeon - he drives a Mini and his daughters attended the local comprehensive.

'I used to think 30 stone was fat, but that seems like nothing now. The heaviest patient I have operated on was a 23-year-old man who weighed 55 stone. To get him to hospital, builders had to take out a window for the Fire Brigade to get a crane into the bedroom as he was too big to get down the stairs.'

'He's still got a long way to go, but he would have been dead by the time he was 30 if he'd not had the operation,' says Mr Super. 'Obesity surgery saved his life. It's hugely satisfying to help in cases like that.'

Critics say gastric bands are an easy option for those too greedy to diet and too lazy to exercise.

'Many patients don't tell their friends,' says Mr Super. 'I have operated on a number of women who haven't even told their husbands.'

Yet while much attention has been paid to the cosmetic results (gastric banding is now offered by many of the large plastic surgery groups), medics argue the real story is the clinical benefit.

There are strict rules about who can be fitted with a gastric band. The National Institute for Health and Clinical Excellence (NICE), which provides guidelines for medics, says surgery should be considered for patients with a BMI - a height and weight ratio - of more than 40. A BMI of more than 25 is classed as overweight, 35 or more is classed as obese, the medical term for when bodyweight causes ill health.

Osteoarthritis, breathing problems, type 2 diabetes, heart disease and polycystic ovary syndrome - a condition in which multiple cysts develop in the ovaries, compromising fertility - can all be caused by obesity.

Those with a BMI of between 35 and 40 who have a condition that poses a serious related health risk are also eligible. These guidelines apply to both NHS and private patients.

If these trends continue, 60 per cent of men and 50 per cent of women will be of BMI 30 or over by 2050.

The current cost to the NHS of treating overweight and obese individuals - that is, either treating the obesity or, more often, treating illness that is a direct result of excess weight - is estimated to be

'This operation is not about fitting into a pair of skinny jeans,' says Mr Super. 'There is a generation of obese children who will die before their parents.

'Obesity wrecks health, but for a long time it has been known that many conditions can be simply treated by weight loss alone. Successful weight loss is very hard to accomplish with diet alone. Gastric band surgery works.'

In contrast, recent research carried out at the University of California in Los Angeles found that 95 per cent of those who lose weight through diet alone regain it all within five years.

Another of Mr Super's success stories is 32-year-old Teresa Perks, who has lost an incredible 15 stone after having a gastric band fitted in February 2006. She and her husband Simon, 34, who works in plastic manufacturing, live in Cheltenham, Gloucestershire, with their four children, Jack, ten, Reece, nine, Harvey, six, and Kaitlin, four.

At her heaviest Teresa weighed 24 stone, and while she is thrilled to be able to fit into size 8 jeans, the biggest reward, she says, is looking forward to a long and healthy life as a wife and mother.

'I really piled on the pounds with my first pregnancy,' she admits. 'I snacked all day, cooked dinner for the children and ate with them, and then again when Simon got home. When we married in 1999, my dress was a size 24.'

Three months into her last pregnancy Teresa developed gestational diabetes, which occurs only in pregnant women, especially those who are overweight. The body becomes resistant to the effects of the hormone insulin - essential for moving sugar out of the blood and into cells where it is used to create energy.

Teresa had to inject herself with synthetic insulin four times a day to control her blood glucose levels, and doctors warned if she didn't lose weight once she'd had the baby, she was likely to develop type 2 diabetes, and have to inject for the rest of her life.

'It was a huge shock,' says Teresa, who booked herself in for the gastric band operation with Mr Super at private hospital Spire Parkway after seeing a TV documentary. The operation cost I had to do something. I didn't want to get ill.'

Two weeks after her initial consultation with Mr Super, Teresa was scheduled for surgery. 'Mr Super made it clear that the band wasn't a miracle cure and it would only work if I made it work,' she says.

Like all gastric band patients Teresa was advised to consume only liquids, such as nutritional milkshakes and soup, for a week after the operation, moving on to 'mushy foods, like potatoes or steamed fish, anything that can be cut with a fork, for another week'.

'After four weeks,' she says, 'you can eat normally again, but I felt full after a few spoonfuls.'

After six weeks the band was tightened, and there was a further month on the same restricted diet.

'I was given a list of foods to avoid, such as rice and pasta, which can swell in the stomach, and red meat and chicken, which are hard to digest.'

Teresa says the weight literally 'dropped off'. After six weeks she had lost three stone. In 12 months, she had shed 11 stone in total. Today she weighs in at nine stone.

But Teresa has lost friends. 'I've had negative comments - that I cheated and somehow don't deserve to have lost weight. But anyone who thinks having a gastric band is an easy option is wrong. Eating a whole sandwich takes me an hour. If I rush a meal, I am sick.'

And as a result of her restricted diet, Teresa developed anaemia, when not enough red blood cells are produced due to a deficiency of iron. 'I felt tired and lethargic,' she explains. 'Now I'm taking a supplement, I feel much better.'

Additional information:

Gastric Lap- Band Surgery Can Send Diabetes Into Remission
Lap Band - ( Gastric Band - Slimband)
Gastric Banding Surgery for Weight Loss
Gastric Band - Blogs, Pictures, and more on WordPress
Laparoscopic Adjustable Gastric Band Surgery, Health Facts For You
Tenfold rise in gastric band op for fat Scots - Scotland on Sunday
Woman has child after gastric band surgery helps her lose 9st
Imaginary Gastric Band Helps Woman to Lose Weight - Neatorama
How much do I need to weigh for a gastric band ?
Gastric Band Surgery Or Diet And Exercise

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