Obese left to struggle as transformative surgery is barely funded here
Specialist says Ireland needs at least 2,000 surgeries a year
A WEIGHT loss surgeon believes Ireland should be carrying out at least 2,000 operations every year to tackle obesity.
William Robb says weight-loss surgery is still ‘very stigmatised’ in Ireland and he believes obesity is a misunderstood illness.
Mr Robb carries out between 60 and 100 bariatric surgeries in the Blackrock Clinic every year. The number of bariatric surgeries at St Vincent’s Hospital was in the high 70s from 2018 to 2020 but fell to 17 in 2021 due to the pandemic. University Hospital Galway carried out a smaller number.
Mr Robb said obesity surgery in the public health system in Ireland has been ‘chronically underresourced’ for decades.
‘For a population like Ireland, and the amount of obesity we have, we probably need to be performing 2,000 – or over 2,000 – of these operations per year.
‘But in our public healthcare system, it’s well below the numbers required to address the problem.
‘There are plans to change. There’s a National Implementation Plan, which will hopefully see the appointment of more public consultants and public surgeons to treat obesity. He added that fewer men than women have the treatment, saying: ‘Males are probably less likely to come forward. That’s probably something that we need to encourage and change as well.’
Mr Robb said the most satisfying part of the surgery is the radical transformation in the lives of patients.
‘They can really become active and do sports and activities that they just could not have dreamed of before. They’re able to do things they couldn’t do for perhaps decades of their life.’
In a recent statement, the HSE said it would provide funding in 2022 to ‘increase access and capacity nationally to specialist services including bariatric surgery, providing specialist care in the right place at the right time, reducing waiting times and expanding services nationally’.
With long waiting lists, some Irish patients have been going abroad for the treatment but Mr Robb said patients are often unaware they can qualify to have the procedure covered by health insurance here.
‘There are fairly well-established international criteria for appropriateness for surgery and the health insurance companies have similar criteria for patients to qualify.
‘Number one is if patients have a body mass index of over 40, or if their body mass index is over 35 and they have significant complications from their obesity, they can be considered for surgery.
‘We still find patients with private health insurance who travel overseas and don’t realise they would have been covered to have the treatment at home.
‘I see patients coming back from overseas with good stories to tell, but I also see patients who have come back with problems.’
He also said it is important for patients to have access to follow-up care after weight-loss surgery.
But he said the treatment of weight is still very stigmatised.
‘People are shamed by their weight. There’s a culture of “it is their fault”. Science and everything tells us more and more that weight and obesity is not the patient’s fault and we have to destigmatise it.
‘It is an illness. It’s not a cosmetic treatment. Once a patient’s weight goes over a certain level, their life expectancy starts to drop.’
Mr Robb said there are many reasons for the surge in obesity rates.
‘Even with diet and exercise, while people may lose weight periodically
‘Telling someone with depression to cheer up’
from time to time, it can be very difficult for them to sustain that weight loss. That’s because of changes in the environment of their body, metabolic changes, as well as genetic predispositions.
‘A friend of mine who does a lot of medical treatment for obesity said telling somebody to lose weight by exercising more and eating less is a little bit like telling somebody with depression to cheer up.’
The surgeon is expecting to carry out up to 150 operations next year. He said most people lose a significant amount of weight.
‘Most patients can expect to lose about 70% to 75% of their excess weight within a year to 18 months. Patients can be overweight by 15 or 20 stone, and if you are overweight by 20 stone you might lose 15 stone. It’s life-changing.’