Surgical Reduction of Obesity

More weight loss surgeries needed to help obese patients
Bariatric Operations Information

Obesity & Overweight | Body Mass Index Information | Health Risks of Obesity
Surgery for Morbid/ Malignant Obesity | Surgical Treatment | Panniculectomy Morbid Obesity
Liposuction & Obesity | Weight Loss Surgery | Types of Weight Loss Surgery
Bariatric Plastic Surgery to Remove Loose Skin & Fat

Treatment of Obesity (2)

Preliminary data from a Swedish obesity study of 2000 obese patients treated with drugs who are being compared with 2000 obese patients treated with surgery, shows that bariatric surgery is much more effective in improving quality of life, curing type 2 diabetes, controlling high blood pressure, reducing atheroma, improving rates of employment, and in reducing costs to the health service.

In addition, data from other sources confirm the efficacy of surgery for obesity in improving adverse lipid profiles, sleep apnoea, joint problems, gastro-oesophageal reflux, urinary incontinence, and asthma.

Too Few Bariatric Weight Reduction Ops

If these studies are so convincing, why are fewer than 200 operations carried out each year in the United Kingdom and why are many of them funded privately?

Firstly, there are few surgeons who are trained to treat obesity. Secondly, society is ignorant and prejudiced against patients with morbid obesity because there is a failure to understand that obesity needs treatment just like any other disease. There is also prejudice against surgeons who carry out this type of demanding surgery. Some doctors consider surgery for obesity to be a waste of resources, and others remember the poor results from earlier procedures such as the jejunoileal bypass. There is also a lack of robust data on the costs and benefits.

Success of Weight Reduction Surgery

Since the advent of obesity surgery in the 1950s some procedures have been discarded and others validated for their good long term results. Data from over 14 000 patients on the international register of obesity surgery shows that at 12 months vertical banded gastroplasty and gastric bypass result in a mean loss of 53% and 72% of excess weight, respectively, with operative mortality of 0.17%. Moreover, 93% of patients have no morbidity.

New technology has increased the range of procedures available; the latest technique is the laparoscopic insertion of a gastric band, which results in patients losing about 50-60% of their excess weight and maintaining that loss for at least six years.

Decrease in Co-Morbidity After Weight Reduction Surgery

Regardless of which procedure is carried out by a competent surgeon, it usually results in patients losing more than 50% of their excess body weight during the first 1-2 years after surgery. If the patient is well motivated and given lifelong counselling the weight loss is usually permanent. However, attention should focus on the improvement of comorbid conditions rather than on actual weight loss, since there are good data to suggest that comorbidity decreases as a result of even modest weight loss.

No Medical Cure For Obesity

A medical cure for this disease is unlikely to emerge for some time because of the complexity of the disorder. Several surgical procedures that have been well validated are available if patients can find suitably trained surgeons with the necessary resources. Purchasers and providers are prejudiced against surgery for obesity and it is accorded a low priority, consequently it is being driven into the private sector where only the rich can benefit. Insurance companies will not pay for surgery because they do not understand that the procedures are cost effective. In 1991 a survey of all general surgeons in the United Kingdom showed there were only 38 obesity surgeons; most were doing only a small number of operations. A repeat survey two years ago showed that the number had dropped to 23. It is little wonder that in this area the United Kingdom is so far behind Europe, the United States, and Australasia.

Bariatric Resources Needed

An obesity surgeon should be available in all large hospitals together with the relevant multidisciplinary team. Doctors and the public will have to agitate for more resources to treat morbid obesity. When the Swedish obese subjects study finally reports the full advantages of bariatric surgery, our profession will be under pressure to train more obesity surgeons to alleviate this often fatal disease.

Back to Page 1 of Obesity Surgical Treatment

See also:
Body Mass Index
Obesity Levels USA
Obesity Levels Worldwide
Obesity Risk For Diabetes
Morbid Obesity Surgeries
Treatment Of Obesity
Effects of Surgery on Morbid Obesity

John Baxter, Professor of General Surgery. Postgraduate Medical School, University of Wales, Swansea SA2 8PP © BMJ 2000


Bariatric Surgery

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Laparoscopic or open bariatric surgery, such as gastric banding or bypass is not an easy solution to morbid obesity and weight loss. It is a serious surgical procedure, involving health risks. To produce lasting weight loss it requires a long-term patient commitment to eating a healthy diet and following a regular program of physical exercise. Life-long use of nutritional supplements may also be necessary. So, before deciding, discuss your options fully with your doctor. © 2003-2018 Bariatric-Surgery.Info - Terms - Contact - Information - Resources