Recent research
using the Health Survey for
England has estimated that 5.4% of the adult English population, or 2.1
million people, are eligible for bariatric
surgery. The surgery is often the last resort for people who have attempted
to lose weight in other ways and who are dangerously obese. People with a Body Mass Index (BMI) of 40 or
above are eligible,
as are people with a BMI of between 35 and 40 who have a condition which would
be improved if they lost weight. These conditions include problems such as diabetes
and high blood pressure, as well as arthritis and coronary heart disease. The
paper found that about 4% of the population have a BMI between 35 and 40, and
have one of these conditions, while another 1.4% people have a BMI of over 40.
The surgery is known to be more
effective in terms of losing weight than other strategies but the numbers
of people undergoing it are far lower than this estimate of the numbers
eligible. Although they have been rising rapidly in recent years, still less
than 10,000 are conducted
every year. This has led to speculation that the surgery is under-provided, particularly in some areas,
perhaps made worse by local commissioning decisions.
While it is true that demand for bariatric surgery now
outstrips supply, it seems unlikely that the issue of obesity will be solved by
surgery alone. Last year the Academy of Medical Royal Colleges issued their prescription
for obesity with a focus on avoiding the
blame game and involving both individuals and organisations in the fight.
Their recommendations include support for healthcare professionals in raising the issues with patients,
a focus on issues such as junk food advertising, and making it easier for people to be more active
in their daily lives. While some individuals will doubtless benefit from weight
loss surgery, any serious attempts to deal with obesity will be severely hampered
by a focus on individuals alone.
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