Three charts on: Australia's growing rates of weight loss surgery

Hospital admissions for weight loss surgery more than doubled in the last decade, new data from the Australian Institute of Health and Welfare (AIHW) show.

That may sound like rates are high, but it is important to remember only a tiny fraction of Australians are eligible for weight loss surgery, and very few are getting it in our public hospitals.

Weight loss surgery, also known as bariatric surgery, includes laparoscopic adjustable gastric band, sleeve gastrectomy and gastric bypass operations. The surgery allows only small meals, that satisfy like larger ones. Experts consider it a highly effective treatment for obesity where diet and exercise haven’t resulted in weight loss.

Like all major surgeries, it carries risks, but laparoscopic procedures available these days make it less invasive than it once was.

What does the new report show?

Weight loss surgery in public hospitals is rare

The AIHW report, Weight loss surgery in Australia 2014-15: Australian hospital statistics, showed that admissions to hospital for weight loss surgery grew to 22,713 in 2014-15, up from about 9,300 in 2005-06.

Of the 22,713 weight loss operations performed in 2014-15, about 90% were performed in private hospitals, highlighting the difficulty in accessing this type of surgery through the public system.

Most operations were ‘primary procedures’, not removals or fix-ups

About 79% of the weight loss surgeries performed in 2014-15 were “primary procedures”, meaning it was the first time the patient had undergone surgery of this type. Secondary procedures include occasions where, for example, a gastric band needs to be re-positioned or removed.

More women than men are getting weight loss surgery

Women represented the vast majority of Australians choosing to undergo weight loss surgery and this dominance was reflected across all age groups.

Women are over represented in all weight loss treatment programs, which may reflect a lower psychological burden experienced by obese men than obese women. There may also be, in general terms, a reluctance among men to act until health issues such as diabetes develop.

The report said nearly two-thirds of Australian adults are overweight or obese – more than two-thirds (70.8%) of adult males, and over half (56.3%) of adult females. Overweight and obesity disproportionately affects people from lower socio-economic backgrounds.

Of those who are clinically severely obese (meaning women and men of average height weighing greater that 98kg and 112kg respectively with obesity related complications), few are treated beyond first line behavioural and lifestyle interventions.

Unfortunately, optimal diet and exercise, while very effective at improving health and function, do not generate more than very modest sustained weight loss in the majority of adults. Meanwhile, stigmatisation, discrimination, shaming and blaming continue to dominate our public conversation about clinically severe obesity.

There are no weight loss drugs available on the Pharmaceutical Benefits Scheme and access to public hospital bariatric surgery is extremely limited.

While experts often question the cost-effectiveness of many forms of surgery that are performed routinely, access to this surgery is often seen as controversial.

John Dixon consults to Bariatric Advantage, I Nova, Novo-nordisk, Apollo Endosurgery, Medtronics, and Nestle Health Science. All activities involve advice to organisations with a focus on weight management. He also receives research support and funding from the NHMRC.