Thousands of Irish patients need weightloss Surgery

Thousands of Irish patients could have their life expectancy significantly increased and chronic diseases reversed following obesity surgery, new research suggests.

In a paper to be presented in early September researchers at Galway university hospital and the Galway Clinic followed 118 morbidly obese patients for two years after they underwent gastric bypass surgery. The sustained average excess body weight loss experienced by patients in the study was 55 per cent after two years.

Of patients with pre-existing high blood pressure, more than 80 per cent required less medication after surgery. Two-thirds of those with pre-existing diabetes were able to discontinue medication after the procedure. Some four in 10 with high blood pressure no longer required anti-hypertensive medication after the laparoscopic sleeve gastrectomy (LSG) operation.

Stomach removed

LSG is a weight-loss bariatric procedure in which a large portion of the stomach is removed, reducing it to a quarter of its original size. The restricted size of the stomach leads to a reduced intake of food and a feeling of being full earlier in a meal. The benefits of LSG are not just due to reduced gastric capacity but also because it modifies the release of gastrointestinal hormones.

Most of the patients in the Galway study, which will be presented at the Freyer international surgical symposium at NUIG on September 5th, had a body mass index (BMI) of 40 or more. All participated in a rigorous long-term weight loss programme before referral for consideration for bariatric surgery. There were no deaths in the study group.

Prof Oliver McAnena, consultant gastrointestinal surgeon at Galway university hospital (GUH) and the Galway Clinic, who operated on the patients in the study said, “Studies have shown the life expectancy of people with severe obesity is severely compromised if they are not offered the option of bariatric surgery. It is a cost-effective intervention but is a serious operation that requires careful patient selection.”

Thousands affected

Co-author Dr Francis Finucane, consultant endocrinologist at GUH, said that 1-2 per cent of Irish people severely affected by obesity could benefit from bariatric surgery. “However only a proportion of the thousands of Irish people affected will be suitable for bariatric surgery or will seek it,” he said.

While acknowledging plans for the State to fund 400 bariatric operations annually by 2018, Dr Finucane said, “There is an element of discrimination of obese patients that limits the application of surgery. If this was cancer or heart disease, and not severe obesity . . . these surgical interventions would be used more widely.”

The latest figures show that 23 per cent of Irish men and 22.5 per cent of Irish women are obese ie their BMI is over 30. Many people who lose weight regain it over time.

Weight loss surgery is now recognised as an effective and appropriate treatment for patients with a BMI of 40, or a BMI of 35 with related illnesses such as diabetes and hypertension