Evidence note 28
Bariatric surgery in adults
This evidence note updates evidence
note 19 published in August 2007.
Background
Bariatric surgery is a branch of general surgery which enables
obese patients to lose weight. New guidelines in Scotland recommend
that it is used only when other weight management methods have
failed to significantly improve comorbidities. Various surgical
procedures are available, which can be based upon a restrictive
approach, in which the volume of the stomach is reduced, a
malabsorptive approach in which nutrient absorption is limited, or
a technique which produces both effects. In 2008, 111 gastric
banding and 178 gastric bypass procedures (including those in the
independent sector) were undertaken on patients living in Scotland.
In 2008−2009, there were 157 bariatric surgery procedures carried
out by the NHS.
Key Messages
There is a body of evidence demonstrating that surgery is more
effective than non-surgical interventions for weight loss outcomes,
particularly in patients with high body mass indexes. A number of
comorbid conditions can be improved or resolved with bariatric
surgery. Recent health technology assessment evidence,
while limited, is indicative that bariatric surgery is a cost
effective intervention compared to non-surgical management for the
treatment of obesity. Generalisability of the cost effectiveness
results to Scottish care settings is contingent upon the inclusion
of other costs, eg plastic surgery. Based on available clinical and
cost-effectiveness evidence, it is currently not possible to
prioritise any particular patient group.
A Scottish Health Technologies Group publication
This evidence note will also inform the National Planning Forum
subgroup established to examine the provision of obesity services
in Scotland.
The Scottish Intercollegiate Guidelines Network (SIGN)
Guideline No 115, Management of Obesity, is also available for
further information
Published Date: 05 August 2010
