The NHS should increase rates of bariatric (weight loss) surgery to improve benefits for patients and reduce long-term healthcare costs, according to experts.
Weight loss surgery has been shown to be a very effective treatment for obesity, which is a leading cause of type 2 diabetes. Surgery either involves reducing the size of the stomach with a gastric band or removing a portion of the stomach.
Furthermore, the cost of surgery can be accounted for by savings on prescriptions and daily blood glucose monitoring. Surgery can also help some patients return to work by improving their physical activity.

The UK has the second highest obesity rate in Europen, but it ranks 13 out of 17 for EU countries for rates of bariatric surgery.
Richard Welbour, bariatric consultant surgeon at Musgrove Park Hospital, UK and colleagues conducted a review of bariatric surgery rates in The BMJ. They found that weight loss operations in the UK have actually been falling in recent years.
“Despite obesity levels increasing, and bariatric surgery being shown to be clinically effective and cost effective, NHS bariatric procedures are falling,” they said. “Between 2011-12 and 2014-15 the number of operations fell by 31 per cent, from 8794 to 6032. This is in stark contrast to provision in many European Union countries.
“Rates of surgery also vary within the UK, with no NHS operations in Northern Ireland and few in Wales and Scotland. Given the severity of the problem, it seems urgent to consider the potential barriers to surgery.”
Welbourn and colleagues explained that there could be a number of barriers to bariatric surgery. These include GPs being unable to refer patients directly to surgical services and instead requiring them to undergo diet and weight management.
The authors suggest that “combining provision of secondary care medical and surgical management so that patients have access to surgical assessment earlier” could help with the health of patients and save long-term costs.
“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.”
Roughly 2.6 million people in the UK meet National Institute for Health and Care Excellence (NICE) guidelines for bariatric surgery. The authors acknowledge that while not every patient can be operated o, the greatest potential for improved health could occur from treating patients with high BMI, type 2 diabetes and sleep apnea.
“Increasing surgery rates to 50 000 a year, which is closer to the European average, could have major benefits for patient health and reduce direct healthcare expenditure within two years, in addition to cost savings in the future from reduced treatment costs.
“We recommend initiatives to overcome the barriers such as communication skills workshops for staff, increased dietetic services, investment in multidisciplinary team working, and creation of metrics for quality assessment with external peer review panels (as seen in the NHS Cancer Plan).”

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