More than 5% of adults in England qualify for bariatric surgery, according to a study by researchers from Imperial College, London, UK. Although this equates to more than 2.1 million adults, unsurprisingly, the paper found that the number of people eligible for surgery ‘far exceeds’ the estimated number of people having procedures.
The study, published in the Journal of the Royal Society of Medicine, found that despite evidence of the cost-effectiveness of weight loss surgery, surgery rates were estimated to be a third of the NHS’s benchmark rate. Researchers, who examined the health of nearly 9,500 people, acknowledged the huge financial implications for the NHS if treatments were carried out in such greater numbers.
Nevertheless, they said more investment may be necessary to meet a growing need for the procedures
“Despite clear guidelines outlining who can undergo such surgery with the NHS, and evidence that these procedures are cost-effective in the long run, less than 1% of those eligible have weight loss surgery each year,” said lead researcher Dr Sonia Saxena. “This raises questions about why more procedures are not currently being carried out.”
Dr Sonia Saxena
NHS guidelines state that bariatric surgery may be offered to those whose morbid obesity could kill them, or to people who are morbidly obese and who have a serious condition such as type 2 diabetes or high blood pressure that could be improved if they lost weight.
The study found that those meeting the criteria for bariatric surgery were more likely to be women, retired with lower educational qualifications and of lower socio-economic status.
“Recent hospital episode statistic data show surgery rates from 2003/4 to 2009/10 have risen year on year in England; with rates highest in women and those aged 40-54 years,” the authors write. “However, service delivery rates still fall significantly below the level needed to support all those who could potentially benefit.”
Several factors contributed to surgery rates being so low, including:
- Those with greatest need for surgery were more often in the lowest socio-economic groups, who are least likely to use healthcare services;
- Patients’ awareness of the possibility of surgery and their commitment to make the necessary lifestyle changes prior to the treatments may also be barriers; and
- Doctors might not be correctly identifying or referring those eligible, and service provision may also be insufficient.
“5.4% of the general adult population is eligible for bariatric surgery in England, far exceeding the current bariatric surgery uptake. Due to the limited capacity of health services to meet demand under existing criteria, greater investment into service provision may be required to meet a growing need,” the study concluded. “This would have significant resource implications. Since those eligible are more likely to be of a lower social class and have lower qualifications, such resources would need careful allocation to ensure equitable access on the basis of need.”
Tam Fry of the National Obesity Forum, said: “The failure to provide appropriate bariatric surgery is a disgrace, the worse so since the surgery pays for itself in two to three years.”
Reportage courtesy of Bariatric News