Obesity Surgery
OBESITY surgery is soaring in popularity, but figures show for the first time that the benefits of the procedure for the average patient fall far short of the costs, making simpler alternative treatments better value for money.
A quarter of Australians over 18 were estimated to be obese in 2007-08, an 8.4 percentage point increase on three years earlier. Demand for obesity surgery is rising even faster.
But figures to be released today show that while it costs $10,935 to give one patient gastric banding surgery — by far the most common anti-obesity operation — the procedure saves only $7567 over the patient’s remaining lifetime on average, costing the system $3366 overall.
The analysis, commissioned by Medibank Private, found better value in drug treatments for obesity, which cost $1566 for a benefit of $2174 per patient over their remaining life.
Best of all were lifestyle programs teaching patients how to eat and exercise better.
Despite their lower success rate — 11 per cent for lifestyle programs, compared with 8 per cent for drugs and 28 per cent for surgery — their much lower cost meant they were the most cost-effective, achieving a benefit of $2846 for a cost of just $1081.
The research, carried out by consultancy firm KPMG Econtech, found the only patients for whom obesity surgery might be cost-effective were the most severely obese.
Like other funds, Medibank Private is experiencing soaring claims for obesity surgery.
The number of its members claiming for gastric banding or gastric bypass surgery has nearly doubled in just two years, from 1752 in 2006-07 to 3484 in 2008-09.
Over the same period, benefits paid out by Medibank for obesity surgery also soared, trebling from $9.46 million in 2004-05 to $30.2m in 2008-09.
Julie Andrews, Medibank’s executive general manager, health management, said the growth in obesity and bariatric surgery was “alarming”.
Health fund NIB recently announced it was cutting entitlements for obesity surgery from two of its products, but a Medibank spokesman said his fund had no intention of following suit.
Federal Health Minister Nicola Roxon said it was “clear that we have a problem in this country with overweight and obesity”.
“One of the most important initiatives that we are trying to put in place is Australia’s first dedicated Preventative Health Agency,” Ms Roxon said.
Drastic obesity measure - surgery for overweight teens
A leading children’s doctor has called for public hospitals to perform bariatric surgery on morbidly overweight adolescents to tackle the obesity epidemic.
The Children’s Hospital at Westmead’s sleep physician Associate Professor Dominic Fitzgerald said the surgery should be offered to teens who had tried and failed other medical therapies.
Doctors are already finalising guidelines on making such surgery available to obese teenagers, with their findings to be presented to the State Government later this year.
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“(Obesity) has become such a crisis that governments are struggling to develop a comprehensive strategy to deal with the problem across the age spectrum,” Professor Fitzgerald wrote in the Medical Observer journal.
“The overwhelming burden of obese children nationwide, and their often chaotic, under-resourced families needing assistance in weight management, has long outstripped the clinical resources available.”
One in four children are overweight or obese.
Bariatric surgery on teenagers has occurred in public hospitals but on “a case by case basis”, a NSW Health spokeswoman said.
Guidelines being drafted will give doctors and families set criteria on whether a child is eligible.
Adolescent physician Dr Michael Kohn, who has reviewed the guidelines, said a morbidly obese teenager aged above 16 who had been in medical weight loss programs for at least two years could be considered eligible.
“The need is very clear,” Dr Kohn, from The Children’s Hospital at Westmead, said.
“Adolescent obesity tracks into adult life and with that can be the early onset of adult diseases such as diabetes, heart disease and cancer.”
Lap-banding involves placing an adjustable band around the stomach using keyhole surgery, restricting the amount of food a patient eats.
Dr Michael Talbot from the Sydney Institute of Obesity Surgery said out of the 1000 procedures he had performed, only a “handful” were for children.
For parents with overweight children, the cost to have surgery privately can exceed $14,000.
But some child experts believe the radical surgery is the wrong solution.
“It may be like plastic and cosmetic surgery, where the insecurities of people are preyed upon to make profits,” health educator Professor Jenny O’Dea said.
“I think you should let a child develop physically, socially and emotionally and let them make the decision when they are an adult.”
Sources:
http://www.dailytelegraph.com.au