Fat-loss ops now only for ’super obese’
HEALTH officials in Derbyshire are to cut back on the number of operations being carried out to help obese people lose weight.
Last year 250 people in the city underwent surgery to have gastric bands fitted to reduce the size of their stomachs – and their appetites.
This will now be restricted to just the “super obese”.
But the move has been criticised by one man who underwent gastric band surgery four years ago after battling with his weight for 15 years and topping the scales at 22 stone.
David Speirs, pictured, has since lost three stone and said: “I think if you’re really desperate for it you should have it, even if you’ve not got any other health problems, because if you keep putting weight on you might die.”
The 43-year-old, of Pear Tree Street, Derby, said surgery had helped him overcome chronic backache and depression.
Derby City General Hospital had been among the first in the country to offer the operations and the number of recipients rocketed from 20 when they were first performed five years ago to an expected 300 this year.
But now health trusts across the East Midlands have decided to ignore national recommendations on eligibility and restrict surgery to the “super obese”.
Instead, they will target their efforts at encouraging people to lead healthy lifestyles and avoid weight gain.
They believe it is a much better use of their resources and have announced plans to dramatically increase spending in this area.
A spokesman from East Midlands Specialised Commissioning Group said: “When looking at what to prioritise spending our money on, the local primary care trusts decided to invest significant funds in measures aimed at preventing obesity and have prioritised community-based projects.
“Surgery is a last resort. The emphasis is on prevention rather than cure.”
Previously, anyone classed as “morbidly obese” – with a body mass index of 40 or more – could be recommended for surgery if alternative weight-loss methods had failed.
That was in line with recommendations from the National Institute for Clinical Excellence
The national guidance is not enforceable because it is only a recommendation.
Now gastric banding is only be offered to those classed as “super obese” – those with a body mass index of 50 or more.
People between 45 and 49 on the index could also have surgery but must first show signs of serious health problems such as diabetes and heart disease.
Paul Leeder, consultant obesity surgeon for Derby’s hospitals, said: “We have estimated that these new changes will lead to a 40% decrease in eligible referrals.
“However, referral numbers are increasing all the time, so the overall impact may not be so great.
“Surgery for obesity has always been considered a procedure of last resort.
“People should all have tried diet, exercise and medical treatments before considering surgery.”
The restriction was put in place following talks between the region’s primary care trusts, which oversee healthcare at a local level, and the East Midlands Specialised Commissioning Group, which is in charge of over-seeing specialist treatments in the area.
They agreed to spend less money on surgery and more on community health projects to prevent weight-gain and encourage healthy lifestyles.
As a result, Derbyshire County Primary Care Trust, which oversees healthcare in the county outside Derby, will spend more than £1.5m on weight management programmes for children and adults between April this year and March 2010.
This is an increase of more than £500,000 this year.
A spokesman for the trust said new programmes would include a scheme to help people with more serious weight problems.
The trust will also continue to subsidise physical activity sessions for obese people who meet a certain criteria.
NHS Derby City is investing £700,000 in obesity prevention and other measures that will encourage people to lead a healthier life.
This does not include a number of existing services and treatments such as nutritionists, medication and surgery.
A spokesman said: “This is the first year we have identified a budget for obesity.
“In previous years the cost was not accounted for in the same way, even though the activities around obesity were similar.”
Steps being taken include the city councils b-active programme, which aims to make sure that children have two hours of physical activity per week at school and another seven one-hour sessions of activity.
The spokesman said: “Derby has a well established programme to encourage both adults and children in the city to become more physically active – the b-active initiative.
“We also have a well-established height and weight monitoring programme in local schools which has consistently performed well above average.”
The East Midlands and the North West have the highest number of obese hospital patients in the country, according to figures earlier this year.
Story courtesy of This is Derbyshire


