Obesity treatment in crisis

Friday January 22nd, 2010

Treatment of obesity in Britain was in crisis last night as a common drug was banned and surgeons complained about lack of support for surgical procedures.

The difficulties of treating the most seriously obese were highlighted by a warning of growing numbers of serious complaints about so-called bariatric surgery - which is used to restrict patient stomachs.

At least one patient has died from infection in the last two years - and several cases of severe complications have been reported to the Medical Defence Union.

The problems were highlighted as drug regulators banned the drug Reductil (sibutramine) Europe-wide.

The drug had its licence suspended by the European Medicines Agency after experts concluded it was linked to an increased risk of heart attacks and strokes.

The Medicines and Healthcare products Regulatory Agency said no new prescriptions should be issued for the drug - and pharmacists should cease dispensing it.

Dr June Raine, of the MHRA, said: "Evidence suggests that there is an increased risk of non-fatal heart attacks and strokes with this medicine that outweigh the benefits of weight loss, which is modest and may not be sustained in the long term after stopping treatment."

The Medical Defence Union said there had been a "dramatic rise" in claims made by bariatric surgery patients in the last two years.

It said it had received 35 cases since 2003, more than half since 2007.

The MDU said problems mainly occurred in private surgery. The most expensive claim is expected to cost the insurers some £500,000.

It called for patients to be given full information about the risks of the procedure - and also what diet was needed after surgery and how much weight they could expect to lose.

It said surgeons should be properly trained and follow guidelines issued by the National Institute for Health and Clinical Excellence.

The problems emerged the same day as the Royal College of Surgeons held a conference to plead for fairer access to the procedure for patients across Britain.

Cash-strapped primary care trusts have been ignoring national guidelines and placing restrictions on patients getting treatment, surgeons said.

Several will only fund it for the most severely ill patients - whilst some refuse to commission any surgery.

The RCS said some 240,000 people want surgery but only 4,300 operations were performed last year. The NICE criteria could mean one million people having surgery.

Surgeons say restrictions might encourage some desperate patients to put on weight to qualify for surgery.

Surgeons claim the procedure is cost-effective as it can help prevent heart disease and diabetes.

RCS director of education, a bariatric surgeon, Professor Mike Larvin, said: "In many regions the threshold criteria are being raised to save money in the short term meaning patients are being denied life-saving and cost effective treatments and effectively encouraged to eat more in order to gain a more risky operation further down the line."

Dr David Haslam, chair of the National Obesity Forum, said: "Bariatric surgery is amongst the most clinically-effective and cost-effective specialities in any field of medicine, preventing premature death, and transforming lives, whilst saving vast amounts of money for the NHS and the economy."

But PCTs won some support from commentators with a Daily Telegraph editorial stating: "The number of obese people is growing so rapidly that surgery cannot possibly be offered to all of them."

Tags: Diet & Food | Europe | Fitness | Pharmaceuticals | UK News

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