Gastric banding: The 'quick fix'

You may be aware that there has been some stuff in the news over the last couple of days about gastric surgery. This is because figures have come out that showed a 40% increase in the number of people getting gastric surgery via the NHS (over the last year, I think). As a result, some of the popular TV and radio channels have been running stories on gastric surgery.

Last night I was driving home from work and listening to the Radio Five Live 'Drive' show. There was a phone-in and the presenter was provocatively asking a caller why obese people should even consider the 'drastic' solution of gastric surgery. She said; "instead of going for the 'quick fix', why don't they [obese people] just adopt a healthy eating lifestyle and get some exercise?" Well, I have to confess that there was almost a pile-up on the M62 at that point because I nearly choked on my own saliva! Quick fix?! Gastric banding is many things, but quick fix it most definitely is NOT!

Unperturbed, and finding myself on a long journey to Birmingham today (more about that in a separate post), I tuned into the radio again. I got bored with listening to people banging on about the financial woes of the world and switched to Radio 2. And waddya know? They were just about to start a phone-in on the topic of gastric surgery.....! The presenter, Jeremy Vine, was asking people to phone in on the question of whether the NHS should 'foot the bill' for all these obese people to have surgery. He suggested that perhaps gastric surgery should be regarded as a cosmetic procedure and patients should pay for it themselves. This provoked some strong opinions in both directions, including from the infamous Ann Widdecombe MP, who argued that the limited budget of the NHS should not be stretched to paying for gastric surgery. Her argument was, that whereas a person who is, say, going blind, cannot do anything about their condition - an obese person can do something about theirs. Therefore, conditions that individuals have no control over should always come higher up the priority list than obesity.

I see the logic in this argument. However, Ann Widdecombe and her trusty band of followers are missing several crucial points, most of which were raised by subsequent callers. First, the cost of gastric surgery (about £7-8000 paid for privately) is a drop in the ocean compared with the costs of treating people in older age for obesity-related illness (e.g. chronic heart failre, diabetes, mobility problems etc). If the NHS spends a little now - on appropriate obese people - it will certainly save in the long run. Second, there is an implicit assumption that people who are obese are greedy, lazy, inactive gluttons - and they should jolly well get up off their fat a***s, do some exercise and just stop putting things in their mouths! Do these 'thin' people really think that we like being fat? Do they not think we have tried all sorts of remedies - and failed? Do they not know that many obese people have psychological, emotional and physical problems that are the root cause of their obesity? It's a bit like saying to an alcoholic, "just stop drinking" - oh if only it were that simple!!! We are not all blessed with acres of willpower - or even common sense!

The third thing is this. Where do you stop? Ann Widdecombe was essentially saying that any illness or medical condition that we can conceivably be thought to have brought upon ourselves should not be supported by the NHS. So, does this mean the NHS will stop treating smokers? Or alchoholics? Or rock-climbers (my own brother nearly killed himself in a fall off a mountain a few years ago and had to be rescued by air ambulance - so I know all about this!). What about peple who wear stilletos and have to have bunions treated?! What about dental treatment - how about we ALL pay for the full cost since we are probably responsible for tooth decay because we eat too many sweets or don't clean our teeth properly! What about people who get bowel cancer - perhaps their diet earlier in life contributed to them geting it? This all sounds a bit bizarre, but I hope you get the point - as soon as the blame culture becomes central to when or how we provide medical treatment, there is no sensible end in sight - where do you stop? Personally, I believe the NHS should exist to provide the full range of treatments for all - including gastric surgery for serious cases. It has to manage its limited budget in the best way it can, but this should not be by artificially excluding people who are regarded as somehow being to 'blame' for their condition.