Scotland has one of the highest obesity rates in the world. The problem will only get worse
Too many obese patients across Scotland are being refused life- transfor ming operations, according to a leading surgeon.
The number of weight-loss operations, including gastric band and sleeve procedures, has fallen by more than 40% but surgeon Majid Ali believes more patients could be helped by surgery but are being ruled out.
Mr Ali, who runs the bariatric unit at the University Hospital of Ayr, a leading centre for weight- loss surgery, said his department, one of four in Scotland, accepts a broader range of referrals than most but still rejects most patients.
The number of operations has fallen from 270 on 2010 to about 159 in 2018, with the downward trend expected to continue. Mr Ali’s unit carries out approximately 30 operations a year but says the surgery, which costs less than £ 10,000 per patient, would save the NHS money in the long-term.
Mr Ali said: “In Ayrshire and Arran we reject more than 80% of patients who are not referred because they do not fit NHS National Planning Forum criteria. Obesity is a chronic and a complex disease. I would like to see the stigma attached to obes i t y a d d re s s e d and more money allocated to bariatric surgery.”
The surgeon pointed out that obesity is now the biggest cause of cancer after smoking. And it can lead to heart disease and diabetes, as well as orthopaedic problems. He said bariatric surgery can cure Type 2 diabetes and help prevent other serious illness.
He wants to see bariatric procedures used as an integral tool in the fight to counter the obesity epidemic, alongside other measures such as physical and dietary education.
And he insisted the price of the procedures was a “drop in the ocean” when compared to the Scottish Parliament Information Centre’s estimated £ 600 million cost to NHS Scotland of overweight and obese patients.
Mr Ali insisted: “If the Scottish Government tackles the problem head on it will save money.”
Statistics released to The Sunday Post through NHS Information Services Division Quality Indicators reveal health boards in Scotland are now performing fewer weight-loss operations – from 270 in 2010/ 11 – when restrictive criteria for patient eligibility was set by the NHS Planning Forum – to 159 in 2018/19. The latest figures, up to March 2019, show the number of operations has dropped by 41%.
The Scottish Gover nment has stressed there has been no change in criteria for bariatric surgery since 2012, and it was up to individual health boards to set their own spending
‘
priorities. But Mr Ali believes more action is needed. He said: “Scotland has one of the highest obesity rates in the world. The problem will only get worse.”
A Scottish Health Survey published in 2016 showed 29% of the Scottish population had a Body Mass Index ( BMI) of at least 30, and so could be defined as obese. Two- thirds ( 65%) were overweight.
He said: “National Institute for Health and Care Excellence criteria says anybody with a BMI above 35, with medical conditions that can be cured or improved with the operation, is eligible for bariatric surgery, as long as they are fit for surgery and anaesthetic.
“When I introduced this surgery at this hospital in 2007 I opened the gate for everybody who fits NICE criteria. We got an influx of people and could not cope. So in 2010/11, with our colleagues in Scotland on the National Planning Forum we agreed on NHS criteria, which is a very restrictive criteria.”
Mr Alisaid: “If you have 30% of people in Scotland with a BMI above 30,