12 Questions
Weight loss surgeon Dr Richard Babor, star of TV2 show The Big Ward, says tens of thousands of morbidly obese New Zealanders would benefit from bariatric surgery but that’s not a solution to the obesity epidemic
1This is the second season of The
Big Ward. What was the response like to the first? The first season was unexpectedly successful, I think because it told interesting human stories. It’s also had real educational value. My job has got easier because pretty much everybody who comes in wanting bariatric surgery has seen the show. In the second season we have a broader cross-section of society to show that obesity affects all socioeconomic groups. MP Paula Bennett is the perfect example of someone who is educated, affluent, health literate and highly motivated but can’t regain control of her weight. I see many successful people like her in my private practice. 2You were one
of only two surgeons doing bariatric surgery when the first season was shot. How many are there now? There are five surgeons doing bariatric surgery at Middlemore Hospital now. I do between 80 and 100 weight-loss operations a year. I could do twice as many if I didn’t do cancer surgery but that takes priority because it’s time-critical and there’s only two of us doing upper gastro-intestinal cancer surgery. I also do on-call acute surgery every second week.
3Only a small percentage of the tens of thousands of people who would benefit from bariatric surgery will qualify under the public health system. How do you prioritise? We use a Ministry of Health scoring system which is mandatory for public hospitals in New Zealand. Patients have to have a major obesity-related health problem that has already brought them into contact with the hospital system like diabetes, osteoarthritis, bad sleep apnoea or fatty liver disease. Weight loss surgery is going to save the health system money in these cases because they’re going to have fewer heart attacks and strokes and less need for things like kidney dialysis or laser treatment for retinopathy. Diabetes is the top qualifier because it has the most costly long-term health
effects. 4What’s life like for those who don’t qualify? Surgery could bring a whole range of improvements to their quality of life. A 32-year-old woman who weighs 130kg might feel confident enough to get a job, a partner, start a family, have a fuller, happier life and come off anti-depressants. But those things aren’t taken into account by the rationing system. 5Should the Government be funding more bariatric surgery? Surgery is a powerful tool to help individuals but you can’t use surgery to fix the obesity epidemic. Over 20,000 people are morbidly obese in South Auckland alone. We’d have to have 20 surgeons working 24/7 and the hospitals wouldn’t have space to do any other surgery. So that’s not