Obesity Surgery Not Available for Many Who Need It
Obesity surgery (gastric bypass or gastric band surgery) is a safe and effective way of preventing diseases common in overweight people, but getting access to this type of surgery is difficult for many Australians, according to an article published in the current issue of the Medical Journal of Australia.
Although Medicare currently pays for privately insured patients to undergo obesity surgery, uninsured patients are denied the same service in public hospitals.
The authors of the article, Michael Talbot, John Jorgensen and Ken Loi of the Department of Surgery, University of New South Wales, say that overweight and obesity may now be more prevalent risk factors for disease than smoking. The prevalence of both obesity and diabetes has doubled in Australia in the past 20 years, and the upward trend is likely to continue.
Management guidelines published by Australia's National Health and Medical Research Council (NHMRC) and by similar US and UK bodies have recommended surgery as the most effective treatment available for selected patients with extreme obesity. Targeting patients with complications of obesity, including type 2 diabetes, could lead to substantial cost savings for the public health system.
As the prevalence of obesity is significantly greater in lower socioeconomic groups, there are a significant number of obese people excluded from treatment that has been recommended by the NHMRC, say the authors.
Although managing obesity is going to be a problem of major proportions, the longer we wait, the more difficult it will be to find solutions that suit the Australian population.
"Surgery for obesity is regarded by many people, including clinicians, to be akin to cosmetic surgery, a perception that is likely to persist while it remains solely the domain of the private system", say the authors.
"The first step will be to acknowledge the severity of the problem and to offer treatment based on best available evidence. To do otherwise is to either ignore the evidence or simply discriminate against the obese", they conclude.
The Medical Journal of Australia is a publication of the Australian Medical Association.
CONTACT Dr Michael TALBOT, 0422 993 070
Judith TOKLEY, AMA Public Affairs, 0408 824 306 / 02 6270 5471