surgery on its own can’t help the obese

There’s no doubt that obesity is a public health crisis. Just this week came figures showing that in 2017 there were more than 10,000 hospital admissions in england alone due to people being seriously overweight.

That’s an increase of a fifth in just two years.

About two-thirds of those were for bariatric surgery — weightloss operations such as gastric bands or bypasses — that dramatically cuts the amount of food a person can comfortably eat.

surgery costs the Nhs about £5,000 a time, but increasingly we are told that it can help reduce the obesity epidemic.

Yet I don’t think weight-loss surgery is the panacea it is made out to be. I assess patients before and after this type of operation and it’s far more complex than the advocates make out.

As well as leading to dietary issues, the rapid weight loss it brings can result in saggy skin, which people feel ashamed and embarrassed about.

Yet that pales into insignificance beside the psychological difficulties involved. Often, people overeat as a way to cope with psychological problems. After bariatric surgery, those problems remain, but patients are now unable to use their only coping strategy.

At a loss as to how to deal with their emotions, many patients have told me they feel it’s as if they’re being mentally tortured.

so it is perhaps unsurprising that around 20 per cent of those who have the surgery regain a significant amount of weight they lose after the operation by finding new ways to eat more.

some even liquidise the chips, burgers, cake and chocolate that they would otherwise be eating so that they can sip it throughout the day and consume the same amount of calories despite their stomach being smaller.

It only emphasises how these people had a profound problem with food before surgery, and an operation can’t hope to cure this.

A study of 17,000 people who had the surgery found they were at higher risk of suicide, probably because of the psychological pressures they encounter postsurgery. research has also shown a 50 per cent increase in drug and alcohol addiction post-surgery — probably because people look to other things to provide the comfort that food used to.

We need to offer therapy to address the problems that have resulted in people being overweight. A psychological problem needs to be addressed psychologically, not surgically.

Teaching people coping strategies to deal with their emotional difficulties can stop their need to use food as a crutch, and so they lose weight anyway.

We cannot get on top of the obesity epidemic until we change the way we think about it.