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Taxpayer-funded weight loss surgery not so bad for the public purse

Date

Natasha Boddy

Publicly funding bariatric surgery for obese people can make economic sense

Publicly funding bariatric surgery for obese people can make economic sense

Publicly funding bariatric surgery for obese people can make economic sense, according to research done at the Royal Prince Alfred Hospital in Sydney.

The research team found obese people who had publicly-funded surgery lost significant weight, with diabetes, hypertension and sleep apnoea resolved in more than half of patients within a year of the procedure. 

Although there has been doubts about the motivation of obese patients whose surgery is fully subsidised, the study suggests "patients reliant on public health care maintain sufficient intrinsic motivation" to lose weight. 

The team, led by Associate Professor Tania Markovic, analysed data from obese patients who underwent publicly-funded bariatric surgery and found there were "marked reductions" in type 2 diabetes, hypertension, lipid disturbances such as cholesterol, and sleep apnoea post-surgery.

The research, published in the Medical Journal of Australia on Monday, found 65 patients lost an average of 17 per cent of their pre-operative weight three months after surgery, 26 per cent within a year and 29 per cent within two years. 

Their body mass index decreased from an average of 48.2 before surgery to 35.7 by two years. 

Associate Professor Markovic said the study had found there were "benefits in almost all the common complications related to obesity", such as diabetes, hypertension and sleep apnoea.

"Obesity tends to affect more lower socio-economic groups and currently bariatric surgery is largely in the private sector," she said.

"It's an expensive procedure that's not covered by Medicare. These are the patients that are often most in need of the surgery who miss out on it. We found these patients do do well and when you do the economics, the cost analysis, one could argue that it is certainly worthwhile when you consider how expensive it is to look after somebody who has got, for instance, type 2 diabetes largely related to their weight."

Associate Professor Markovic said there could many medical conditions associated with obesity, which in themselves could be costly to treat. 

"If we just look at something like type 2 diabetes, I think, we quoted in the order of $15,000 a year but there can be other problems, there can be sleep apnoea, respiratory failure, gastrointestinal problems," she said. 

"The cost of somebody with complicated obesity with medical problems is high."

The study's authors wrote that improved access to publicly-funded bariatric surgery could "justifiably reduce the health inequalities for those most in need".  

The research appears to bolster the ACT government's move to provide publicly fund bariatric surgery in 2014-15. The funding will pay for about 13 procedures. 

No surgeries have yet been performed. 

An ACT Health spokeswoman said patients had to meet strict eligibility criteria. 

Patients must be aged over 18, have a BMI greater than 40 and have been referred to the Obesity Management Service by their GP. They also need to be assessed by the Obesity Management Service as meeting the "criteria for surgical intervention", the spokeswoman said. 

Associate Professor Markovic was hopeful consideration for increasing the supply publicly-funded bariatric surgeries in Australia would be boost by her team's research. 

15 comments so far

  • Fund it with taxes on shite foods

    Commenter
    Franky
    Location
    Sydney
    Date and time
    August 18, 2014, 12:03PM
    • agree, just add 5 cents to junk food and sugar drinks. In UK they also want to add 1 penny to takeaway grog to fund alcoholic rehab.

      Commenter
      stoney
      Date and time
      August 18, 2014, 12:45PM
  • Catch 22 with this one...have to say it is easier to to pay for it now than have the massive cost later in life with all of the other health problems encountered by the morbidly obese. But how do you change the food choices that people make?

    Commenter
    Big T
    Location
    ACT
    Date and time
    August 18, 2014, 12:20PM
    • Or the obese people can own their condition and do something about it (maybe in addition to surgery).

      Funding this is both good and bad. Assist those that do want to change (although cannot afford it), however, changing ones diet and going for a walk around the block? The first may be cheaper than people realise and the second is free. From an economic point at the moment, yes it would be cheaper to 'fix' those that are overweight to limit the costs on the health system in the future.

      ....How about people not getting obese in the first place without deflection. *cues argument for medication, marketing and genes*

      Commenter
      Daily reader
      Location
      Melbourne
      Date and time
      August 18, 2014, 12:26PM
      • Funding for nutritionists and personal trainers is good, but funding for surgery is not good. Surgery doesn't modify people's behaviours.

        Commenter
        Sharron
        Location
        Canberra
        Date and time
        August 18, 2014, 1:38PM
      • Bingo.

        Via the awesomeness of maths, it may be more cost effective to button up the bigger folk thus forcing them to eat less, lower their weight and have less impact on health costs in the long term. But staples don't change what is going on up top, as said @Sharron. Even with surgery a LOT needs to change for a real impact and benefit for all involved.

        Put down the burger and eat some fruit before walking to the corner store, you might be surprised at the high level of yum.

        Commenter
        Daily reader
        Location
        Melbourne
        Date and time
        August 18, 2014, 3:08PM
    • This is great news. When can I book in for my tobacco receptors to be removed?

      Commenter
      Deutsch
      Location
      Canberra
      Date and time
      August 18, 2014, 12:40PM
      • Most people are also addicted to food, especially sugary and fatty food, just like nicotine. In a sense everything can be seen as a drug with greater or lessor addictive properties. Tobacco companies in the 1960s actually added increased nicotine to the cigarettes to make them more addictive and augment sales. But whether it is the tobacco industry or the food industry, people are being duped and having their health sacrificed. They are the play things of purely (large) profit driven industry that takes zero responsibility. Ever wonder why governments are always trying to prop up the health industry? Co-payments of $7 etc? We've never had such a high rate of avoidable diseases in the human race, all taking the medical budget towards impossible levels .

        Commenter
        Don't blame the people
        Date and time
        August 18, 2014, 1:32PM
    • It should be treated no differently than any other medical procedure. Medicare is there for everyone.

      Commenter
      Johnno
      Location
      Canberra
      Date and time
      August 18, 2014, 12:46PM
      • The people who should be paying for this are the food industries that continue to make high calorie sugar and fat filled junk food in our supermarkets. Anything in a packet, tin, or bottle needs to be closely examined (always fine print) to see just how much sugar, trans fat, and other toxic ingredients are added. It is all making people overweight so unless you go back to basics you don't stand a chance. Of course this industry is complimented by the diet and weight reduction industry, that is just as predatory on the same individuals. Then there is the take-away junk food industry that has exploited every human weakness to make massive profits. They now employ the same lawyers as the Tobacco lobby to argue that their food is nutritious, and in no way linked to the modern increase in diseases such as heart disease, diabetes. dementia,and Alzheimers. All of them blame the consumer for obesity, but the consumer has little chance not to be duped. They want you to feel guilty - its good for the dieting industry. Essentially the food industry is like other big business, they all display a focus on profits but refuse to deal with the mess they create. We wouldn't need weight loss surgery if healthy food could be genuinely and honestly promoted.

        Commenter
        Don't blame people
        Date and time
        August 18, 2014, 1:09PM

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