The tabloid press was outrage by the possibility that ‘TWO MILLION obese Brits‘ could be offered bariatric surgery, after NICE guidelines recommended that weight loss procedures should be offered to people with diabetes and a BMI of over 35. The story was front-page news, with lurid estimates of the potential cost.
But why the outrage? Leaving aside the dubious figures (NICE estimates an additional 5000 surgical procedures a year if their advice is implemented), bariatric surgery is an effective treatment for a condition, type 2 diabetes, that causes serious disability and suffering. Dr Rachel Batterham, head of obesity and bariatric services at UCL, who developed the NICE guidance, says: ‘The health benefits of weight loss surgery are so great that it should be considered as part of the treatment for obese diabetics.’ She said people should be offered surgery as soon as possible after their diagnosis, for best results.
Persuasive evidence suggests that bariatric surgery not only cuts the chances of people with obesity getting type 2 diabetes, but that it can reverse the condition. NICE says that 65% of people with diabetes who had bariatric surgery last year are no longer in need of diabetes medication. That’s fantastic news, surely?
The outrage, of course, is not because of diabetes, but obesity. A caller to this week’s Any Answers programme on Radio 4 briskly asserted that anyone who needed healthcare because of ‘self-inflicted’ problems such as smoking or obesity did not deserve NHS treatment. They were, she said in a jaw-dropping display of judgementalism, lazy and lacking in self-control.
And that’s the heart of the argument against bariatric surgery. Never mind that NICE makes it a pre-condition that people should try to lose weight by other means before being considered for surgery, or that it’s a major operation which can have serious consequences. Never mind that we live in an obesogenic society, and that most people having surgery have spent years miserably trying and failing to lose weight. Forget that reversing the tide of diabetes could save the NHS money in the long term. People don’t like to see others getting something they don’t think they deserve – even if that something is a gastric band.