Bariatric Surgery: More Is Still Not Enough



Bariatric surgery is now widely considered by far the best effective long-term treatment for severe obesity – the long-term benefits on morbidity and mortality are well-documented (not to say that there cannot be problems in individual patients, but overall, the average outcomes are pretty remarkable).

That said, bariatric surgery is still not as widely available in Canada as surgical treatments for other health issues.

Nevertheless, over the past decade, yearly bariatric surgery rates in the Canadian public healthcare system have increased from around 3,000 a year in 2009 to over 8,500 in 2016.

However,  as pointed out in the  2017 Report Card on Access To Obesity Treatment For Adults, released last week at the 5th Canadian Obesity Summit, despite this increase, only about 1 in 200 Canadians with Obesity Class II or III would have access to surgery per year (at this rate it would take 200 years to do everyone eligible today).

What is also the remarkable is the variation in access to surgery from one province to the next. For e.g. while 1 in 90 eligible patients have access in Quebec, the corresponding number for Canadians living in Nova Scotia is 1 in 1,300, an almost 15-fold difference in access!

I can think of no other disease or treatments that would have a 15-fold difference in access between provinces.

Not quite as dramatic are the differences between Alberta (1 in 300) and its direct neighbour Saskatchewan (1 in 800). Even Newfoundland and Labrador does better with (1 in 390).

With these low rates, every province (except Quebec) gets an “F” for access and waiting times that range from 18 months (Alberta) to 60 months (Nova Scotia).

So, yes, while access to bariatric surgery has certainly improved in Canada in the last decade, getting it remains a rather long haul – a significant number of years of life lost, if you’re facing serious health problems from your obesity.

@DrSharma
Edmonton, AB