Weight loss surgery works. Why is the NHS so reluctant to offer it?

Weight loss surgery should be made more freely available on the NHS, according to a report in the British Medical Journal.

The NHS should be performing 50,000 surgeries a year, according to the report by Professor Richard Welbourn, one of the UK’s most prominent bariatric surgeons. He argues that such a move would reduce healthcare costs in the long term, and says it makes no sense that as obesity levels are increasing, NHS bariatric procedures are falling.

Between 2012 and 2015, the number of operations fell by 31 per cent, from 8,794 to 6,032. And fewer than one per cent of those who could benefit from the surgery are treated, the report says.

Although the UK has the second highest rate of obesity in Europe, it is 13th out of 17 in terms of bariatric surgery provision.

According to Welbourn, studies have shown that bariatric surgery, which reduces the size of the stomach with a gastric band or through the removal of part of the stomach, is clinically effective and cost-effective, and helps patients reduce their weight by as much as 25 to 35 per cent within a year.

The new research suggests that the costs of surgery can be recouped within three years. ‘GPs and commissioners need to recognise the health benefits gained from bariatric surgery and the cost savings. This will facilitate better provision of secondary care services and help address concerns of upfront surgery costs being another barrier,’ the report says.

Instant analysis
Britons are the second fattest people in Europe, behind only Malta. A quarter of us are obese. Bariatric surgery, which reduces the intake and absorption of food, is effective for about a third of the morbidly obese. It not only reduces their weight but controls the type-2 diabetes to which many of them are susceptible.

According to this paper, Britain lags behind in the use of bariatric surgery. Up to 2.6 million people might benefit from it, but in 2014-5 only 6,032 people underwent it. If we had the same rates of surgery as other European countries, 50,000 people a year would have the surgery.

People have to go through elaborate vetting procedures before surgery that reduce the amount of surgery done. Once again, the beloved NHS performs poorly by comparison with other health care systems.
TD
Research score: 4/5