Weight of evidence

The weight-loss industry never seems to slim down. Now it is no longer just liposuction that surgery offers. Bariatic surgery, which deals with the treatment of obesity, is another option, but isn’t a quick fix. Like any operation, it has its risks – and people carrying extra weight often face problems with anaesthesia.

The National Institute for Health and Clinical Excellence (Nice) recommends weight-loss surgery, but only in specific circumstances: it is considered suitable for adults with a body mass index of greater than 40kg/m2, or for those with a BMI above 35kg/m2 who have another condition such as high blood pressure or type 2 diabetes and who have been unable to lose weight through diet, exercise or medication. The patient must receive intensive care via a specialist obesity service, and is encouraged to submit to long-term follow-up. Nice also recommends that surgery is used in the first line where the BMI is above 50kg/m2.

This kind of surgery usually consists of reducing the size of the stomach or bypassing it. It is often successful: one study found that there was a mean reduction in body weight of 23.4 per cent after surgery. However, this study didn’t compare surgery with medication used for weight loss – and indeed a lack of comparative evidence is one criticism levelled at the surgery.

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