‘Fat Britain’, says the Daily Mail, in a report on the growing number of gastric bypass operations reportedly costing the NHS £85 million a year. The media has reported extensively on weight-loss surgery for obesity today, with The Daily Telegraph saying that the number of gastric bypass operations has risen six-fold in only five years.
So far in 2011-12 there have been 1,316 gastric band insertions and 124 gastric band removals performed for obesity under the NHS. This compares with 715 insertions and 11 removals 6 years ago. There have also been 5,407 gastric bypass procedures performed under the NHS for obesity, compared to 858 5-6 years ago
What is the basis for these current reports?
The stories come following the Health and Social Care Information Centre’s publication of Hospital Episode Statistics (HES) on the number of surgical procedures for gastric band insertion, maintenance and removal, as well as gastric bypasses that have been performed on the grounds of obesity during the period from 2006-07 to 2011-12. The HES data for England is collected by the NHS Information Centre for Health and Social Care, which also collects statistics on the care provided by NHS hospitals and for NHS hospital patients treated elsewhere.
The Information Centre cautions that the data for 2011-12 is provisional, and may be incomplete or contain errors at the current time. They do say though, that the finalised figures are likely to be higher.
How many gastric band procedures are being performed?
A gastric band is an inflatable band that sits around the top of the stomach. Inflation of the band narrows the stomach, limiting it’s capacity to take food and increasing the feeling of fullness. This effect leads to weight loss.
The Information Centre reports the following for the number of procedures for gastric band performed under the NHS over the last five-six years:
- 715 insertions
- 11 removals
- 1,044 insertions
- 45 removals
- 1,382 insertions
- 46 removals
- 1,638 insertions
- 1,519 maintenance procedures
- 82 removals
- 1,555 insertions
- 1,444 maintenance procedures
- 125 removals
- 1,316 insertions
- 1,618 maintenance procedures
- 124 removals
Before 2009-10, gastric band maintenance procedures were not recorded separately in the database.
These figures are reported as what are called “finished consultant episodes”: a continuous period of care for a patient admitted under one consultant, within one healthcare provider. They could be either first procedures or secondary procedures. These treatment episodes are documented for the year in which the treatment ends.
The figures also do not represent the number of patients treated, as a person may have more than one episode of care within the same stay in hospital, or in different stays in the same year.
The primary diagnosis under which these treatments were performed was obesity.
How many gastric bypass procedures are being performed?
A gastric bypass is when the small intestine is attached to a small pouch that is created from the upper part of the stomach, which is then linked to the intestines. Reducing the size of the stomach limits the amount of food that can be consumed and bypassing the first part of the intestines limits the amount of nutrients absorbed.
The Information Centre reports the following for the number of procedures for gastric bypass performed under the NHS over the last five-six years:
- 2006-07: 858 procedures
- 2007-08: 1,312 procedures
- 2008-09: 2,533 procedures
- 2009-10: 3,745 procedures
- 2010-11: 4,722 procedures
- 2011-12: 5,407 procedures
Who is eligible for weight-loss surgery?
Clinical guidance on obesity from the National Institute of Health and Clinical Excellence (NICE) advises that weight-loss (bariatric) surgery can be considered as a treatment option for adults if all of the following criteria are fulfilled:
- they have a BMI of 40 kg/m2 or more, or between 35 kg/m2 and 40 kg/m2 and other significant diseases (for example, type 2 diabetes or high blood pressure) that could be improved if they lost weight
- all appropriate non-surgical measures have been tried but have failed to achieve, or maintain, adequate clinically beneficial weight loss for at least 6 months
- the person has been receiving or will receive intensive management in a specialist obesity service
- the person is generally fit for anaesthesia and surgery
- the person commits to the need for long-term follow-up
NICE also recommend bariatric surgery as a first-line option (instead of lifestyle interventions or drug treatment) for adults with a BMI of more than 50 kg/m2 in whom surgical intervention is considered appropriate.
Lifestyle advice for weight loss and information on weight-loss medications can be obtained through the pages about obesity.