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10 November 2014
Second UK bariatric report shows safety and effectiveness of surgery

The Second National Bariatric Surgery Report published by the British Obesity & Metabolic Surgery Society (BOMSS) and Dendrite Clinical systems reports that bariatric surgery in the UK is safe with an observed in-hospital mortality rate after primary surgery of 0.07% and an overall surgical complication rate for primary operations of 2.9%. The report also highlights the effectiveness of surgery; two years after surgery 65.1% of patients with type 2 diabetes returned to a state of no indication of diabetes and were able to stop their diabetic medications, and three years after surgery patients on average lost 59.6% of their excess weight.

The report is the second comprehensive, prospective, nationwide analysis of outcomes from bariatric surgery in the United Kingdom and Ireland, and a result of the data collected by the National Bariatric Surgery Registry (NBSR).

"The NBSR is the major source of data on the effectiveness of UK bariatric surgery. I am very happy to say that results from the NBSR shows that patients with severe and complex obesity can continue to have confidence in bariatric procedures," said Mr Richard Welbourn, Consultant Surgeon, Chair of the NBSR and the President of BOMSS.

The publication has data from 161 surgeons from 137 hospitals who recorded 32,073 operations (18,283 in the three financial years ending 2011, 2012 and 2013). The vast majority (76.2%) of the procedure were funded by the National Health Service and the report includes information on 9,526 gastric bypass procedures, 4,705 gastric band operations and 3,797 sleeve gastrectomy operations.

"The aim of bariatric surgery is to improve the overall health of patients by ameliorating, curing or preventing the development of the many diseases associated with obesity,à€ the reports notes. à€œIn this regard weight loss is not a primary aim of surgery. However, weight loss is a convenient and important proxy measure of the effectiveness of surgery."

"Perhaps most importantly, this second report demonstrates the commitment of British surgeons to share their data in the interests of understanding and improving the quality of care they offer,à€ writes Professor Sir Bruce Keogh, Medical Director of the National Health Service in England, in the Foreword of the report. "The pooling of so much data will help define the place of surgery for people debilitated by obesity and will, in time, help to refine surgical strategies and even unravel the mystery of why this surgery has such an instantaneous, profound and beneficial effect on diabetes, another scourge of our society. In short, this report is a tribute to the professionalism of the British Obesity & Metabolic Surgery Society."

"Severe and complex obesity is a life-long condition associated with many major medical conditions, the cost of which threatens to bankrupt the NHS. For severely obese people, medical therapy, lifestyle changes and attempts at dieting rarely succeed in maintaining long-term, clinically beneficial weight loss due to the hormonal effects of being obese," added Mr Welbourn. "Our data shows that there is great benefit from bariatric surgery for all the diseases studied, in particular, the effect on diabetes has important implications for the NHS. Bariatric surgery cost-effectively improves the health of obese patients."

In the foreword to the NBSR Professor Sir Bruce Keogh, Medical Director of the NHS says: "Obesity and bariatric surgery are rapidly rising up the NHS agenda as a consequence of social and lifestyle choices. As in all branches of medicine, prevention is better than cure, but this report clearly demonstrates that when required, bariatric surgery is effective and safe. This is based on detailed data on over 18,000 patients. The survival rate of over 99.9% and the decreasing length of time spent in hospital is all the more impressive given the increasing illness of patients being sent for surgery."