By Derby Telegraph |
A DIETICIAN said weight-loss surgery should still only be used as a "last resort" – because it does not address the underlying causes of obesity.
The comments by Helen Bond – dietician at Castle Inn Dietetic Clinic, in Melbourne – come after health watchdog the National Institute for Health and Care Excellence, or NICE, said that gastric bypass and sleeve gastrectomy surgery should no longer be seen by doctors as a last resort.
Two million people in England could be eligible for the £6,000 operation, which NICE said should now be considered for patients with a body-mass index (BMI) of 30 and type-two diabetes if they have completed a weight-loss programme.
It has been estimated that, if all those in that group took up the offer, it would cost the NHS £12 billion.
NICE also recommended patients should be offered a surgery assessment even without completing a weight-loss programme if they had a BMI of 35 and type-two diabetes.
But Helen, whose clinical specialities include general healthy eating and type-two diabetes, said: "Surgery does reduce the risk of complications from type-two diabetes and, in that respect, it will save money . But it's a very invasive procedure and not something which should be done lightly.
"Weight loss is not just something physical – it is also mental and behavourial. Surgery in itself does not change the way you eat and exercise . I think it should be a last resort because there are still many dieting interventions."
NICE said the NHS could reap "huge financial benefits " in the long-term, as 65% of post-operation patients would no longer need any diabetes medication within two years. It said they would also avoid serious and costly conditions such as heart failure, amputations and blindness.
Professor John Wilding, a consultant physician in diabetes at the University of Liverpool and Aintree University Hospitals NHS Foundation Trust – who helped develop the guidance – said he would like to see the number of operations on obese diabetics go from an average of 4,000 a year to 15,000 a year.
Paul Leeder, consultant bariatric surgeon at the Royal Derby Hospital, said: 'Type-two diabetes is becoming an huge burden for the NHS. Most cases are due, at least in part, to excessive weight.
"The mainstay of weight control for these patients should remain non-surgical.
"There is now very good evidence that surgery can help where diets have not been successful."