Fletcher and Patrick suggest that the use of bariatric surgery “is always going to be limited and a last resort.”1 I disagree. Bariatric surgery has a major impact on type 2 diabetes.2 Over 6000 bariatric surgeries are performed annually in Canada, one-third in Quebec alone.3 If the United States is any indicator, we should be doing 20 000–25 000 surgeries per year.
Many Canadians go very south of the border (Mexico, Dominican Republic, Costa Rica, Brazil), where surgery is often performed in facilities whose conditions are unknown. Many patients come home with complications, resulting in a much higher cost to taxpayers.4
It is possible to increase the number of Canadian operations to 50 000–60 000 per year, and have 1% of the population treated within seven years. The investment would be recouped within three to five years.5 At present, bariatric surgery is the only proven treatment for severe obesity as societal changes are unlikely to have an impact in the next decade.6
References
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