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Study offers ‘definitive proof’ for bariatric surgery benefits

By Lilian Anekwe

GPs have called for better access to bariatric surgery for obesity after an academic report found the procedures resulted in substantial weight loss and significant improvements in type 2 diabetes and other obesity co-morbidities.

The first UK audit by the National Bariatric Surgery Registry, published this week by the Royal College of Surgeons, included data from 8,710 operations carried out in the NHS and private sector, and detailed for the first time the effects of obesity surgery in treating a whole range of diseases.

GPs and surgeons said the figures provide evidence that obesity surgery is one of the most clinically effective, safe and cost effective treatments available to the NHS.

But previous Pulse investigations found although hospitals and PCTs have seen a 650% rise in referrals for surgery in five years, GP referrals that meet NICE criteria for obesity surgery were being sent back by more than half of consultants as trusts across the country placed caps on referrals, raised referral thresholds or refused to take any referrals from primary care.

Data from 86 hospitals found that after 12 months of follow up, patients lost, on average of 57.8% of excess weight, and recorded improvements in hypertension, dyslipidaemia, type2 diabetes and sleep apnoea.

Long-term sufferers of illnesses such as type 2 diabetes – some of whom had the disease for more than ten years – took the longest to go into remission, suggesting the best health gains for patients are to be made by operating early in the disease progression.

Surgeons called for the Department of Health to invest in a long term strategy to ensure that all patients have equal access to treatment delivered by teams at specialist centres that offer a full range of treatment options, such as gastric bypasses and gastric band procedures.

Mr John Black, president of the Royal College of Surgeons said: 'This audit provides unquestionable evidence that bariatric surgery is cost-effective when the billions of pounds spent in the NHS treating obesity-related problems are taken into account. It is a false economy to cut funding for this type of surgery.'

Dr David Haslam, a GP in Hertfordshire and chair of the National Obesity Forum who worked on the report said under GP commissioning was an 'opportunity for GPs to shake off the shackles of specialist and PCT commissioning and ensure that these methods of surgery are embraced to their full potential.'

He told Pulse: 'It's should finally put to rest the controversy around gastric bands and gastric by-passes. It's definitive proof that these procedures are clinically effective and cost effective. Even the most cynical, fat-phobic person would have to be convinced now.'

Dr Paul Singer, a GP in Luton whose practice took part in the Couterweight Project to tackle obesity, said: 'There's no doubt that there is a strong argument for bariatric surgery for people with diabetes and metabolic syndrome. It would be good to have a small number of specialist centres offering treatment rather than having it widely available from local centres with less activity.'

Study offers 'definitive proof' for bariatric surgery benefits