Just 20% of obesity surgery patients are men

Four out of five obesity surgery patients are women. That's one of the less trumpeted figures in the first ever UK report by the National Bariatric Surgery Registry (NBSR).

Surgeons say the figures in the report provide evidence that obesity surgery is 'one of the most clinically effective, safe and cost effective treatments available to the NHS'. Data from 86 hospitals including private ones show that, by the time they reach surgery, around two thirds of severely obese patients (those with a body mass index of 50+) will have three or more associated diseases. Almost three quarters of patients have limited function – are unable to climb 3 flights of stairs without resting; a third have high blood pressure; over a quarter have diabetes; nearly a fifth have high cholesterol and one sixth suffer from sleep apnoea. Of patients with a 12 month follow up, figures show that as well as losing on, average, 57.8% of excess weight, improvement is recorded in all associated disease.

The NBSR say the report also demonstrates that obesity surgery is being introduced into the UK safely. 'An in-hospital mortality rate of just 0.1%, compares favourably with other forms of established surgery and equals the best published international data for bariatric surgery.'

Cost-effective

The surgery is also, apparently, cost-effective. Research shows that the cost of bariatric surgery is recouped within three years of surgery as obesity associated costs are eliminated, with diabetes alone estimated to cost the health service £3,000 per patient per year for life, while the direct costs of treating obesity related illness is £5bn per year, and set to double by 2050. Currently NICE guidelines state that people with a body mass index (BMI) of 40 or more or those with a BMI of 35 plus associated diseases should be considered for surgery.

David Haslam, GP and Clinical Director of the National Obesity Forum, is among those championing this form of intervention. 'Not only is this audit important in detailing the problems associated with obesity,' he said. 'It also outlines the remarkable benefits that bariatric surgery is routinely inducing.'

If surgery is so beneficial, it must be worth asking why men receive it so much less frequently than women.

True, women are more likely to be dangerously obese than men. According to the Health Survey for England 2009, 4% of men and 6% of women have a BMI of 35 and over and 1% of men and 3% of women have a BMI of 40 or more. But this is not a four fold difference. Are men less likely to be offered weight-reduction surgery or less likely to take it?

• NBSR press release