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Bariatric surgery

Obesity is at last being recognised as potentially the most serious healthcare issue in developed countries. For seriously overweight people, it is not just a question of the risk of developing Type 2 diabetes, cardio-respiratory disease, liver disease, hip and knee joint failure and other musculoskeletal disorders; it is a question of when these problems will occur.

Morbid obesity affects 1–2% of the population so no GP practice will be without seriously overweight patients. The NICE Health Technology Appraisal of 2002 recognised that many of these patients are incapable of losing weight without intervention and that weight loss or ‘bariatric’ surgery could not only achieve life-changing results for patients but at the same time was cost-effective in reducing the inevitable costs that will be incurred if no action is taken.

Before going any further, a health warning is appropriate. Bariatric surgery is not on a par with cosmetic surgery. It requires a fundamental change in attitude to eating. Good results are only achieved by a multidisciplinary approach that carefully combines both behavioural and physical issues. Surgery without specialist behavioural assessment and on-going support can be not just ineffective in the longer term but positively dangerous.

Other forms of surgery

Other surgery exists for a range of issues, from cosmetic dental surgery to laser eye surgery to repair conditions such as myopia and astigmatism.