A decade ago the idea of fitting a gastric band around someone’s stomach to stop them eating was the stuff of surgical extremes. A handful of cases a year demanded such severe action.
But as Britain’s obesity rates have soared, so an ever greater number of people have been pushed off the scales and into surgery.
Should primary care trusts have seen it coming? It was as easy to spot as the alarmingly fast advance of the legions of the very fat. Take a look around the average classroom, and you will see teenagers already slipping towards early-onset type 2 diabetes, high blood pressure and heart disease — or the costly “get-out” of gastric banding.
And the procedure does not come cheap. “Banding” usually costs between £5,000 and £7,000 if done privately (and insurance may not pay, as it is deemed a chronic disease).
So the health service must pick up a weighty tab, even if it is managing only 50 per cent of the 10,000 operations carried out per year.
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Health trusts can set aside only a certain amount of money for such surgery each financial year, and are doubtless finding that the pips are squeaking. Nice guidelines or not, judgment must be made on an increasingly inconsistent case-by-case basis.
Even once on the patient list and through the operating theatre (there is a risk of infection, and in rare cases, leaking into your stomach) the process is not easy. Once the gastric band is in place, diets must be followed meticulously. The band can be adjusted externally by a surgeon — tighter or looser, depending on the amount of food the patient must be restricted from eating — with saline solution also used to alter the stomach volume.
In the public eye it may now be a silver bullet escape from years of overweight misery, but it should remain the “when all else fails” option.
What is not being conveyed, by medics, ministers or the media, is that this is no slight cosmetic nip-tuck. This is serious surgery.