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Toronto Ramps Up Access to Bariatric Surgery



As blogged before, last year, Ontario announced $75 Million in new funding for bariatric services (as part of a $750 Million announcement for diabetes care).

In a follow-up announcement to the roll out of these funds, Ontario’s Health Minister Caplan yesterday, at a function held at the Toronto Western Hospital, declared that $12.6 million of these funds will go towards expanding the Humber River Regional Hospital centre of excellence to include five other Toronto sites (Toronto East General Hospital, St. Michael’s Hospital, St. Joseph’s Health Centre, The Hospital for Sick Children and University Health Network’s Toronto Western Hospital site). This conglomerate will be called the University of Toronto Collaborative Bariatric Surgery Program and will function as one of the four Ontario Bariatric Centres of Excellence. (Click here for PDF of the Press Release)

This money will fund an additional 615 bariatric surgeries at the new University of Toronto Collaborative Bariatric Surgery Program by 2011/2012

While this is not additional money, it does represent a massive expansion of current capacity in Toronto.

No question, the demand is there: in 2008/09 Ontario will fund 1,660 patients for out-of-country bariatric services at $10,000 a pop – with virtually no pre-assessment or long-term follow-up. 

As readers of this blog may know, much of what is now being implemented by the Ontario Government is exactly what was recommended by a Health Technology Utilization Guideline committee, which I had the honor of co-chairing during my time in Ontario.

Not only did this report highlight the urgent need to expand access to bariatric surgery in Ontario, but we also stressed that this should happen in the context of expanding access to interdisciplinary bariatric services and obesity treatments that include medical and behavioural inerventions (not just surgery).

After all, as I have oft stated in these pages – the actual surgery is only a small (but important!) technical piece in a complex chronic disease management plan (Obesity Surgery is Not Just About Surgery).

AMS
Edmonton, Alberta

4 Comments

  1. Bariatric Surgery is a poor answer to a nutrition problem that is caused by our food industry adding more and more chemicals, sugars and salt to the foods. Forcing a person to eat less through an operation will only cause them to be even more nutrition starved and to develop a disease depending on their genetic weakness. Someone has not been mentioned here who shares much of the blame for what has been happening in the USA and Indian Nations. When 30% of the population of the USA is obese that has gone beyond diet, exercise and genetics. Through the food industry our food is subjected to poor farming methods, Irradiation, Pasteurization, Emulsification, Over refining, Genetic Modification, and via the animals Steroids and Antibiotics. Then before it gets to us they add Aspartame, MSG, Artificial colors, Sodium nitrite, Hydrogenated oils, High-Fructose Corn syrup, Acesulfame K, BHA, BHT, Olestra, Bromate, Sulfites, Seomyx, and I could go on and on. Good grief, what do they think we are? You and I know that this is not right, our food should not degrade into something chemically unrecognizable. Food should have food value and nourish us not turn us into an obese sickly country, you know it, I know it and they should know it.

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  2. I have just read Mr. Paul Blake’s comment about nutrition being important and bariatric surgery being a poor answer to the problem. I am quite confused as to why he felt that this forum was actually the proper place for his statements. His first sentence states that bariatric surgery is a poor solution to the nutrition problems which he feels was caused by the food industry, and if his major focus and concern is related to the food industry practices that he finds offensive, perhaps this comment should have been placed on a website that was actually having a discussion geared toward this subject! I did not see anything on Dr. Sharma’s obesity notes that even slightly suggested that bariatric surgery was a “good answer” to the nutritional problems Mr. Blake speaks of. In fact, I don’t know of any Bariatric Surgeon who has even slightly suggested that it was an answer to nutritional problems at all!

    If Mr. Blake is so focused on the percentage of the population who is considered to be obese, I can only speculate that he most likely has not done any research on the cause of Morbid Obesity, nor has he studied any success rate percentages pertaining to the various different treatments that have been tried and tested to ‘cure’ the problem of morbid obesity. But my dear Mr. Blake, I can assure you that the number of people in North America who are morbidly obese because of genetically altered foods or chemically unrecognizable foods is probably closer to a 0.0001% as opposed to your belief that 30% of morbidly obese people did not get there because of poor diet, lack of exercise and genetics.

    I believe that Dr. Sharma is trying to make the point that bariatric surgery alone is not the answer to morbid obesity. Instead, he is suggesting that the surgery is simply the jumping off point for those morbidly obese people who have failed at every other attempt to lose weight using traditional methods. The majority of morbidly obese people got this way over a long period of time which was spent using food as an emotional crutch, not exercising, and withdrawing from a society who judged them. The worse their life became, the further they would withdraw into their own world of eating, using the food to make the pain go away. It didn’t matter if the food was processed or chemically altered or if it had one tiny bit of nutrition! If it made them feel good, they ate it. Pizza, ice cream, cakes, soda, fried foods, sugary foods, starchy foods, salty foods….this respresents their drug of choice! So, for you to even suggest that society is morbidly obese due to the food industry chemically altering the foods we eat simply makes no sense and sounds as though you have been misinformed.

    If you would like to comment about how society is affected by chemicals in food and how there are so many overweight people because food is no longer pure and nutritional…fine. That makes sense. But, you chose to post your comment as a direct reply to the doctor blogging about funds for bariatric surgery becoming availalble in Toronto and Ontario. The only people who truly qualify for bariatric surgery are those who are MORBIDLY obese! The obesity has reached such a level that they have multiple medical problems which are life threatening, and by performing a bariatric surgery on these people whose lives are at risk, they are actually given a chance to live. The surgery itself is simply the platform from which to build off of…just as the doctor stated. He was against facilities out of the country being paid $10k by the government medical plan, particularly because these foreign facilities were unable (or chose not to) provide any type of pre-assessment or pre-op care and gave no follow up care to the patients who underwent bariatric surgery. You can not have success by simply offering a morbidly obese person a gastric bypass or stapling or a lap band type of procedure. They need to have mental pre-assessments; they need support groups and nutritional counseling and psychological post-op counseling in order to change what is on the inside after they have managed to change what is on the outside, through the use of surgery.

    Speaking from a level of personal experience, I can assure you that my morbid obesity had nothing at all to due with food industry executives deciding to alter the food I was eating! I was born into a family of unhealthy eaters, and the obesity issues seemed to pass down from generation to generation – going all the way back to my family members who came from Ireland and Wales and ended up as Settlers in Oklahoma. They were overweight when they first arrived at Ellis Iland, and they were overweight when they made their claim for land in Oklahoma. And those ancestors of mine who worked from sunup to sundown to tend to their crops and work the land still ended up being overweight…probably due to the fact that they ate meals at the end of the workday, going to bed with full stomachs – filled with dairy products that came from the animals on their land. The butter my great-great grandmother spent churning…the eggs that came from the chicken in their coops…the red meat from the cows that grazed on their land….the cheeses and the milk that came from their dairy cows….None of these foods were chemically altered by the food industry!! Yet, they were overweight. This problem went down the line, from generation to generation. My Mother and my Father are both overweight. My aunts, uncles, grandparents, great aunts, cousins….everyone has been dealing with weight issues in my family since as far back as I can recall. So, when I had tried to lose weight after the birth of my son, it was extremely difficult. I had no knowledge of how to eat healthy, since there was not one single person in my family that cooked healthy foods, and therefore I learned by example and ate by example. By the time my child was 2 years old, I was at 240 lbs., and I am only 5’4″ tall. So, I had gastric surgery after everything else had failed. I went from a size 24 to a size 2 in one year. But, I had NO follow up, no support. Here I am 15 years later, and my weight has started to creep back up again. Why? because I allowed it to happen. Because I never lost the fat girl mentality in my own mind, and what I thought is what I became. I now have to figure out how to get this 45 pounds back off of me, without the help of a surgery. But, the nutritional problems caused by the food industry that you have referred to is definitely NOT the source of my problem! And, bariatric surgery has never, ever, ever made the claim that it was an answer to a nutritional problem in the first place…so where you came up with that idea, I just think you pulled it out of thin air so that you could rant and rave about it here! Nice try, though…but next time, try writing pieces that are topically relevant to the website you have posted it on. Thanks.

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  3. When I read the above comments from Karen Lynne, my jaw hit the floor! Although her name and mine are spelled slightly differently, everything else in her story is exactly the same. I too had issues with weight, which were passed down from generation to generation. I too had ballooned up to 240 pounds by the time my child was 2 years old. And, my family came here from Wales and Ireland, and were settlers in Oklahoma – who churned their own butter and raised their food on their land. And, I too started to gain the weight back again, 15 years after surgery.

    I think I just found my doppelganger – in an online version! Had she not had written her comments in response to Mr. Blake’s post, I would have had the same reply. In fact, I was scrolling down to reply to his post and was intending to say the exact same thing, when I found the post by Karen Lynne. At first, I thought I had written it myself! But the “e” on the end of Lynne meant that it wasn’t me. It seems as though we have lived a parallel life, coming from the same background, with the same ancestral links to Ireland and Wales and to the settlers of Oklahoma. We both got pregnant and had a large weight gain after our child was born. We both weighed 240 when our child was two years old. We both went from a size 24 to a size 2, and we both are experiencing the weight creeping back on again. The similarities are just mind blowing!

    If you should happen to come back to this web page again and you find this message, please drop me a line at klwd1963@aim.com – I would love the opportunity to speak with you and to share stories…..and to find out how you are handling the weight problems all these years post-operative. I am seeking out a surgeon who can handle a revision, since my surgery has clearly failed over time, and wonder if you have ever thought about doing the same thing? Did you have a stomach stapling or a gastric bypass? Anyway – I’m sitting here asking these questions assuming you will see them! If you do, please send me a message….thanks!

    As to the topic of discussion……gastric surgery for morbid obesity is a life saver for many people who have tried everything else. We can’t blame it on the food industry – that won’t proactively solve our problem. Instead, morbidly obese people who can get this surgery will have to learn a whole new way of eating, and the surgery forces them into it. Follow up care is SO important – something I never had. This is where the surgery fails many people, and I hope that in the years since my surgery that this has changed. By being forced to eat slower and eat smaller portions, our lousy metabolism that we have inherited does begin to change. Weight loss becomes possible, and the physical limitations and medical problems that the excess weight was causing begin to diminish, allowing us the freedom to become more active, and live a much healthier lifestyle. To view this in any type of negative way as Mr. Blake has done is simply ignorant and absurd.

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  4. Dear Karenlynn I just read you post. It sounds llike my story but I never had any surgery. I went to my doctor yesterday and ask him if I should go ahead with gastric roux ny surgery and he to me NO as he said the stomach grows back and he said excess skin could be a problem.At this point I’m thinking of a lapband which is $17’000.00 dollars in Canada the gastric bypass is paid by our health care . I think lapband surgery is pretty invasive to but I don’t like being overweight in the summer or anytime.I have bad knees now so I going to have one of those surgery as the knees are bad. I wish you the best.

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