Data from a recent study carried out by the ESPRIT (Evidence to Support Prevention, Implementation and Translation) research group led by Professor Patricia Kearney at the Department of Epidemiology and Public Health, University College Cork (UCC), estimate that current weight loss surgery (bariatric surgery) provision in Ireland meets less than 0.1% of the need.
Bariatric surgery is an intervention for patients with severe obesity. The study, funded by Prof Kearney’s Health Research Board Research Leader Award and published in the journal Surgery of Obesity and Related Disorders, estimates the number of older Irish adults who are potentially eligible for and likely to benefit from weight loss surgery. It calls for a strategy to develop and expand the provision of bariatric care.
The prevalence of severe obesity and type 2 diabetes (T2D) is rising, which poses a major challenge for public health in Ireland. While public health strategies focus on the prevention of obesity and lifestyle interventions, the treatment of morbid obesity needs to be recognised as a fundamental aspect in tackling the obesity epidemic. Bariatric surgery is a treatment option as it improves life-expectancy and increases the odds of diabetes remission, leading to a reduction in direct healthcare expenditure. However, bariatric surgical procedures are not commonly performed in Ireland. Only two public bariatric centres exist nationally and between them fewer than 50 procedures are performed annually, meeting less than 0.1% of the need for service provision.
The findings of the study show that 7.97% of older Irish adults are potentially eligible for bariatric surgery according to recent guidelines. This represents approximately 92,500 adults in Ireland. It is estimated that 12% of these adults have T2D and related complications. The study suggests that focusing the provision of bariatric surgery on this population cohort would potentially improve both patient outcomes and reduce healthcare expenditure. Dr Francis Finucane, Consultant in endocrinology at Galway University Hospital, states that “It is important that this intervention becomes an accessible treatment option for those in greatest need. We sought to estimate the number of people potentially eligible for bariatric surgery in Ireland based on established clinical criteria and then to refine the number of potentially eligible patients by identifying those who suffer from diseases with high morbidity, mortality and healthcare cost, that respond best to bariatric surgery.”
Data for the study was collected from a cross-sectional analysis of the first wave (2009-2011) of The Irish Longitudinal Study on Ageing (TILDA) to estimate the proportion of people eligible for bariatric surgery. TILDA is a nationally representative cohort study of community-dwelling adults aged 50 years and over.
Ms Kate O’Neill from the Department of Epidemiology and Public Health, UCC states that “Our findings ought to be considered by policy-makers and should be used to guide resource allocation. One strategy to limit the budget impact is to focus on the patients with T2D and related complications. The provision of bariatric surgery to those in greatest need has the potential to improve both patient outcomes and reduce direct healthcare expenditure quickly.”