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The case for bariatric surgery (The Age, opinion)
6 January 2008
FOR thousands of Victorians who are morbidly obese, bariatric (weight-loss) surgery may be their last option. It is a radical option for a radical problem - but the option is out of reach for many because the surgery is not funded in public hospitals.
Many people with morbid obesity can be helped with this surgery. Quite simply, these people's health is in jeopardy. They are more likely to develop type 2 diabetes, high blood pressure, cardiovascular problems, some cancers and a host of other serious ailments.
Morbidly obese people generally will be sicker and will die sooner.
Bariatric surgery is an effective and safe treatment for many people where other treatments have failed.
Only people who have already had many failed attempts at losing weight, who have demonstrated a commitment to a strict eating and exercise regime and follow-up - and are an acceptable operative risk – are considered for bariatric surgery.
Obesity is more prevalent in lower socio-economic groups, but only about 10% of bariatric surgery is carried out in public hospitals. While the treatment is covered by Medicare and available for those with private health insurance, thousands of Victorians who would most benefit from the treatment currently miss out because it is not available in our public hospitals.
Bariatric surgery has an impressive success rate. People who have had the surgery lose 50%-70% of their excess weight.
Up to 80% of patients with type 2 diabetes who have bariatric surgery are cured of diabetes.
The direct and indirect costs of bariatric surgery in Australia are about $10,000, which is about the same as the average cost of managing a diabetic patient for one year. It is a most cost-effective treatment, which should be available for morbidly obese patients.
In the vast majority of cases, the primary cause of weight gain is the combination of too much food and too little exercise. The age-old maxim "eat sensibly, and exercise" is still the most effective way to control weight. Obesity is a complex problem, and the solutions are similarly complex.
Public health campaigns, better environments and lifestyles and encouraging people to maintain a healthy weight are all part of the armoury to prevent obesity.
The weight of Victorians is an urgent public health issue that must be tackled now. Too many Victorians are over their ideal weight, and too many are significantly overweight. The health, economic and social implications of this weight crisis are severe, and demand immediate action. Public funding for bariatric surgery must be part of the answer.
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