The results of a survey out today have raised interesting questions on how weight loss surgery should be funded. Of those polled, 85% believe that obesity is a burden on the NHS, and 29% object to the NHS funding any weight loss surgery. However, nearly half the population (48%) agree with the idea of the individual and the NHS co-funding surgery, a proposal that is not currently an option for patients undergoing weight loss treatment.
The survey, carried out by YouGov on behalf of Spire Healthcare, looked at public awareness of weight loss surgery, health issues surrounding obesity, and attitudes towards the NHS funding of weight loss treatment. The figures show that the nation is in two minds over the role of weight loss surgery in helping those with obesity to lose weight – 43% think it is a good option to help people, but 42% disagree. Almost one in five regard it as a “lazy way out” for people who do not want to diet or exercise.
As well as mixed views on the importance of surgery in treating obesity, it is clear that there is still a high level of ignorance as to the impact surgery has on a patient’s life. Before weight loss surgery, patients are required to prepare for and plan their nutrition and recovery from surgery, with regular follow-ups for at least a year afterwards to help maintain their new and dramatically reduced eating regime. However, only half of those polled knew that patients can no longer eat large portions after their operation, and only 9% are aware that a person can only drink a very small amount of fizzy drinks, due to the reduced size of their stomach.
Mr Bart Decadt Bariatric Surgeon at Spire Manchester Hospital said "that it is interesting but not surprising that the attitude towards weight loss surgery is mixed, both from the population and from the NHS. It is encouraging that the majority of the population is aware that obesity is related to many health problems. However, a lot of people do not realize that obesity surgery is the most effective treatment available at present which can cure or improve many of these obesity related conditions such as type 2 diabetes, high blood pressure, sleep apnoea, reflux disease, PCOS, depression, joint problems and many more. Also, it is less known that bariatric surgery is nowadays very safe with a complication and mortality rate similar as having your gall bladder removed (0.2% mortality rate in 2009-2010 in UK). In NHS England 3642 patients underwent obesity surgery in 2009-2010 which is only 0.3% from those eligible according to NICE guidelines. However, recent data suggests that laparoscopic obesity surgery for diabetes pays for itself in 26 months simply by reducing medication costs alone. If additional economic factors are included surgery pays for itself in one year. Co-funding is definitely the way forward in the current financial climate and may become an option once both the population and the health care providers are accepting obesity surgery as the main tool in fighting the obesity epidemic. This survey has helped us a little in making a step forward."
With figures from the Foresight report1 estimating that by 2025, 47% of men and 36% of women will be obese, the UK is facing a burgeoning obesity problem. However, the survey revealed that there is still a lack of understanding of what this might mean for the nation’s health, and the resulting impact on the NHS. While 81% of people polled recognise that obesity increases the risk of heart disease, only 50-60% of people polled know that obesity can increase the risk of sleep problems, fertility problems and some forms of cancer. However, attitudes to weight loss surgery, for almost half (46%) the last resort in tackling obesity, remain sceptical and knowledge of the procedures involved is limited.
NICE guidelines recommend weight loss surgery for those with a BMI of 40 or more (in some cases 35). However access to weight loss treatments (including surgery) in the public sector is restricted by NHS requirements to make savings. Only 10% of those questioned said outright that weight loss surgery should be funded in full by the NHS. And yet a report released by the OHE2 in September 2010 found that if just 25% of NICE-eligible patients were to receive weight loss surgery, the total net gain to the economy would be £1.3bn.
“It is very interesting that despite a growing need for it, attitudes towards weight loss surgery, and its place in tackling a health burden in the UK, are still very mixed, and this leads to very varied views on who exactly should be paying for it,” said Mr Alan Li, Consultant Bariatric and General Surgeon at Spire Manchester Hospital.
“At Spire, we offer a full range of bariatric procedures for patients, and make it clear to patients that surgery is by no means the easiest or only option available to them. It is clear from this survey that there is still a strong requirement for better and greater education about what these treatments involve and entail, and the benefits they might bring for not only the individual but in tackling a wider growing health issue. Perhaps the NHS should look at the different ways that it could fund surgery as it is clear this is not an issue that is going to go away for some time.”