Surgically Slim

Obesity is the healthcare epidemic of the 21st century. It has become a massive cause of premature death in the UK, killing almost 1,000 people each week. Advice to the population to reduce food intake and take more exercise has been manifestly unsuccessful. Even so, diabetes expert Rachel Batterham created a storm this month when she suggested that the number of Britons undergoing drastic stomach surgery is set to soar. But in our view, she’s correct: surgical procedures are now the only effective therapy for long-term weight loss in the most serious cases.

Most surgical interventions are currently performed laparoscopically – that is, through key-hole surgery. The gastric band operation, for instance, involves placing a silicone band around the top part of the stomach. The band works by creating a small pouch, limiting the amount of food that can enter the stomach, reducing appetite and physically slowing food consumption down.

Another procedure, the Roux-en-Y gastric bypass, involves stapling the stomach across the upper part to create a pouch similar in size to the one formed by the gastric band. Part of the small bowel is then joined to the pouch to allow the stomach to empty directly into it, and the stomach and much of the small bowel is bypassed.

Bariatric (i.e. weight reducing) surgery causes weight loss of between 15 and 30 per cent. It also brings a huge improvement in diseases associated with obesity. Particularly noteworthy is the 80 per cent remission rate for sufferers of type two diabetes. One in three children born after 2000 will develop this disease, with a ten per cent risk of death every ten years. With one sufferer dying every ten seconds, within two years a fifth of NHS resources will be spent on tackling diabetes.

These figures could hardly be more shocking, and they should force home the desperate importance of tackling obesity in Britain. Few—if any—other treatments have such a dramatic effect on obese patients as bariatric surgery.

Of course, surgery alone is not the answer. A third of Scottish 12-year-olds are overweight, and one fifth are obese, according to 2005 figures. Clearly there should be more focus on preventive measures, which would allow the next generation of Scottish children to avoid the complications associated with surgery.

However, for the moment bariatric surgery remains the gold standard against which all other interventions will be measured. While we wait for alternative therapies to be developed, it’s vital that the treatment is made more widely available. The number of procedures in the United States has increased sharply in recent years. Encouragingly, Britain looks set to follow.