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Two million patients eligible for bariatric surgery, estimate researchers

Over two million people in England are estimated to currently fulfil the criteria for weight loss surgery, a number that ‘far exceeds’ previous estimates, say experts.

Their analysis shows that around 5.4% of the adult population in England could meet the criteria for bariatric surgery, although they were unable to exclude those unsuitable for surgery.

The researchers reached their conclusions after cross-referencing data from the Health Survey for England 2006 on patients with a BMI 35 and above, and who have co-morbidities such as hypertension, stroke or type 2 diabetes.

NICE guidelines say weight loss surgery is appropriate only for people with a BMI of 40 or more, or a BMI of 35-40 and a serious health condition. Other conditions apply, including that patients must have tried non-surgical methods such as diet and exercise.

The study - published today by the Journal of the Royal Society of Medicine - found that patients eligible were more often women, retired and those with lower educational qualifications and socioeconomic status.

The researchers concluded: ‘This is the first study to quantify the number of people eligible for bariatric surgery using data from a nationally representative survey in England.’

Study leader Dr Sonia Saxena, a reader in primary care at Imperial College London, called for greater investment in provision for weight loss surgery, as obesity rates continue to rise.

She said: ‘Since those eligible are more likely to be of a lower social class and have lower qualifications, resources would need careful allocation to ensure equitable access on the basis of need.’

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Readers' comments (3)

  • Azeem Majeed

    The increase in the prevalence of obesity seen in England is part of a world-wide phenomenon. The contributing factors include a global shift in diets, with an increased intake of energy-dense foods that are high in fat and sugars. Other factors include sedentary lifestyles and decreased physical activity; and environmental factors such as changing modes of transportation, a shift from manual to non-manual occupations and increasing urbanisation. The medical consequences of obesity include significant impairments of health and life expectancy. For example, diabetes, heart disease, hypertension, cancer and osteoarthritis are all more common in obese people. Obesity also has huge economic implications from its direct treatment costs and from indirect costs, such as sickness absence.

    Although medical and surgical treatments have an important role in the management of obesity, particularly in some high risk groups, the key to tackling obesity lies in wider societal approaches, involving joint working between the NHS, local and national government, and the private sector. There is currently a wide variation in the way in which primary care teams and hospital clinicians manage overweight and obese patients. Frameworks for evaluating the evidence base and effectiveness of local obesity prevention and treatment strategies will therefore be a key step in meeting this challenge. Failure to implement adequate population- based methods to tackle the rising burden of obesity will further increase the public health and economic consequences of obesity, at a time when the NHS and public sector finances will be under severe pressure.

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  • Vinci Ho

    Of course , we all know it is about changing the culture and views of the public in weight management . GPs and practice nurses are trying everyday to educate their patients but clearly one needs to understand if there is an effective treatment which can change outcome substantially , this option needs to be more widely available than current setting, at least for many difficult cases.
    Academics can always say the funding needs to be carefully calculated but even my 13 years old daughter knows paying a bit more first will prevent massive expenditure on subsequent diseases .
    Question is do we trust any government to commit itself with audacity and honesty? I am pessimistic .That BMI threshold of 35-40 with morbidities or 40 alone never happen in reality , let's be honest.

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  • Vinci Ho

    Do remember dishonesty and cowardice always have to be paid for .
    George Orwell

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