Obesity in the UK has assumed epidemic proportions and half the population could be obese within 25 years, according to the British Heart Foundation. Because of this, obesity-related conditions like Type 2 diabetes, heart disease and stroke are also increasing.
One of the ways to tackle obesity is bariatric surgery (also sometimes referred to as obesity or weight loss surgery), though it is used only as a last resort. A study conducted in 2004 by researchers from the McGill University, Montreal, Canada, has shown that obesity surgery significantly reduces mortality rates. Pressure is mounting on the NHS to increase its capacity to handle weight loss surgeries, but it currently does just 46% of the desired obesity surgeries, says the British Obesity Surgery Patient Association. A number of people from UK go abroad for weight loss surgery. Obesity centers in Belgium and India offer obesity surgery solutions that are affordable and quick. Some even visit Mexico for weight loss surgery.
Who is a Candidate for Weight Loss Surgery?
According to a Memorandum submitted by Professor John Baxter to the UK Parliament’s Select Committee on Health, the following are the criteria for an obese person to be considered for weight loss surgery:
- Must be morbidly obese ( BMI>35)
- Must have at least one co-morbid condition which would respond to weight loss
- Must have been morbidly obese for at least five years
- Must have failed conservative treatment
- Must not be an alcoholic
- Must be aged between 18-55
Patients who are not considered for any type of bariatric surgery have the following conditions:
- Severe mental illness, such as psychosis
- Some chronic intestinal diseases, such as Crohn’s disease
- Cancer or other serious medical conditions that make surgery too risky
- Unable to undergo general anesthesia
Wait Times for Obesity Procedures in the UK
The British Obesity Surgery Patient Association receives 4,000 inquiries every month from people desperate for the operation. But, depending on the patient’s postcode, NHS waiting lists can be up to 2-3 years.
It has been estimated that there are about 1.2 million people who fit the National Institute for Health and Clinical Excellence (NICE)’s criteria for obesity surgery in the UK, but there is no way that the NHS can cope with such a figure. The NICE says patients with a BMI of 40 or 35 are eligible for obesity operations, but NHS is so hard pressed that it is giving priority only to patients with a BMI of 45-50.
According to Prof. Baxter’s memorandum, the reasons for poor performance of the NHS in this area are the result of:
- Lack of trained obesity surgeons
- Lack of NHS capacity—especially lack of extra funding for obesity surgery (much of this surgery is done in private hospitals)
- Lack of a decisive approach to management of obesity in general—in particular lack of a regional plan for obesity surgery
- Prejudice by commissioners and health-care staff—in particular lack of pressure on Primary Care Trusts to fund this surgery in trusts
Types of Obesity Procedures Covered by the NHS
NHS offers the following types of obesity surgeries:
- Gastric banding (LAGB)
- Roux-en-Y Gastric Bypass (LRYGB)
- Sleeve gastrectomy (LSG)
Gastric banding: Laparoscopic gastric banding, also known as lap band surgery, is a minimally invasive weight loss surgery. An adjustable band is placed around the stomach to restrict food intake and helps patient feel full sooner.
Roux-en-Y Gastric Bypass: A small stomach pouch is created in the Roux-en-Y gastric bypass to reduce food intake, by stapling a portion of the stomach. This procedure not only restricts the amount a patient can eat, but also limits absorption of calories.
Sleeve gastrectomy: About a third to three-fourths of the stomach is removed in this surgery and the stomach takes the shape of a “sleeve” or “banana”. It has faster weight loss than adjustable gastric banding, but less than the gastric bypass.
It is mainly because of the long waiting time for obesity surgery at NHS that more people from the UK are now going abroad for the surgery. It’s not just the quick treatment that medical tourism promises, but also quality treatment at very affordable prices.
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