Weight loss surgery suitable for obesity-linked diabetes

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NHS guidelines stipulate that those who have received a diabetes diagnosis, which is linked to obesity, should be assessed for weight loss surgery.

The National Institute for Health and Care Excellence (Nice) has decreased the threshold when patients should be considered for weight-loss surgery. All those classified as obese, suffering serious illnesses related to their weight, may now be considered for weight-loss surgery. According to experts, this implies that up to two million people may now be considered and this could result in up to 15000 people per annum being operated on within a short number of years.

Anyone with a body mass index (BMI) score above 30 who has been diagnosed with a weight-related illness would have to be considered.

Weight loss surgery, which is usually done by gastric bypass, is a procedure where the digestive system of the patient is rerouted past most of the stomach. This means that less food is digested and it requires less food to feel full. It is a highly effective surgical procedure and could result in an improvement in conditions linked to obesity, including diabetes and high blood pressure.
It is viewed as a controversial method of weight loss by some people, with critics stating that it should not be seen as an alternative to exercise based and diet weight loss.

However, the new guidance stipulates that those hoping to be considered for this type of surgery should already have completed a medical weight loss programme.

The new guidance is being implemented in the hope that it will save the NHS money over the long-term. The cost of treating diabetes and the complications related to it, costs the healthcare service around £10bn per annum, with around one in six hospital beds being occupied by diabetes patients.

Previous guidance stipulated that bariatric surgery be offered to those with a BMI of 40 or above, or those with a BMI of 35 to 40, if they suffered with a disease that would be improved if weight loss was achieved.

Some weight loss experts said the new guidance increased the risk of ‘normalising’ weight-loss surgery. The head of nutrition and research at Slimming World, Dr Jacquie Levin, said the advice was sending out a ‘worrying message’. She said the choice of surgery should not be seen as a light-hearted decision. It involves risks and can cause increased feelings of failure and lack of control as it places the final solution in someone else’s hands.

There are risks involved with the surgery and some patients have found that they are unable to eat larger meal portions ever again.

The head of the Centre for Clinical Practice at Nice, Professor Mark Baker, said obesity is a huge problem and may become a bigger problem for the NHS over the next few years. He said that we are becoming heavier and the number of obese classifications has almost doubled over the past two decades and is constantly increasing.

Image Credit: Butz.2013

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