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Friday, 19 July, 2002, 11:49 GMT 12:49 UK
Morbid obese to get NHS surgery
Obesity
Obesity is a growing problem
People who are excessively overweight should be offered surgery on the NHS, a watchdog has ruled.

The National Institute for Clinical Excellence says that surgery should be considered for people who are morbidly obese.

This is a technical term for people who have a body mass index (BMI) of 40 or more.

BMI is a calculation which compares a person's weight with their height. A BMI of 20-25 is considered healthy.

NICE has recommended that surgery should be a potential option for adults who have been receiving intensive management in a specialised hospital obesity clinic and who have failed to respond to other forms of treatment.

The ruling applies to people with a BMI over 40, or those with a BMI of 35-40 and associated significant health problems, such as diabetes or high blood pressure.

It is expected to cost the NHS an extra 21m over the next eight years.


We would want to implement the appraisal over a sensible period

Professor Alan Johnson
However, the watchdog also stressed that more specially equipped centres and trained staff are needed.

For this reason it might take several years before surgery is made widely available.

Extreme obesity is a growing problem in the UK. It increases the risk of heart disease, diabetes, cancer and respiratory disorders.

Types of surgery

Surgery has been shown to be an effective way for obese people to maintain weight loss.

It helps improve quality of life, and reduces the risk of disease. However, the procedure itself can pose a risk.


Undergoing surgery to assist with weight loss is a serious procedure, not a quick fix

Professor Peter Littlejohns
There are two main types of surgery, known as 'malabsorptive' and 'restrictive'.

Malabsorptive surgery works by shortening the length of the gut so that the amount of food absorbed by the body is reduced.

Restrictive surgery limits the size of the stomach so the person feels full after eating a small amount of food.

This type of surgery can involve 'stapling' parts of the stomach together or fitting a tight band to make a small pouch for food to enter.

Professor Peter Littlejohns, who led the NICE appraisal, said: " In 1998 it was estimated that over half a million people in England and Wales were morbidly obese, and this figure is rising.

"Undergoing surgery to assist with weight loss is a serious procedure, not a quick fix.

"The guidance we have issued sets out where this treatment sits in a package of care for people with morbid obesity."

Minister's response

Health Minister Lord Hunt welcomed the NICE ruling.

He said: "We asked NICE to look at obesity surgery because we wanted to know if it is a clinically and cost effective way of tackling morbid obesity and so also reducing the other diseases which this condition can lead to.

"It is now important for the NHS to take NICE's guidance fully into account and to develop the necessary services and skills in a planned and coordinated way, therefore also taking account of the impact on other services.

"We intend to issue management guidance to the NHS next week to assist in the implementation of this guidance."

Professor Alan Johnson, the President of the British Obesity Surgery Society (BOSS) said: "Patient safety is our first consideration and we would want to implement the appraisal over a sensible period to allow for surgeons to be appropriately trained and all the support services to be in place."

See also:

06 Jun 01 | Health
30 Mar 01 | Health
01 Jun 01 | Health
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