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Eligibility for bariatric surgery in England

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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