As the country faces a growing obesity problem, an increasing number of people are going under the knife to help them shed unwanted pounds.
Figures obtained through Freedom of Information show the NHS now accounts for almost two-thirds of all the bariatric – or weight loss – procedures in Scotland.
Around 500 weight-loss surgeries are performed annually between the public and private sectors, with each operation costing £7000-£10,000. This compares to around £7600 for a coronary bypass, £5000 for a hip replacement or £750 for a single cataract operation.
A total of 309 bariatric surgeries – including gastric band, gastric bypass, gastric balloon and gastric sleeve operations – were performed last year, compared to 203 in 2007/8. That is an increase of 52%.
The rise has been driven partly by the rolling out of the service from five to eight health boards.
The operations have also been introduced at the Golden Jubilee Hospital in Clydebank, where 23 gastric band operations have been conducted since 2010.
Obesity-related deaths in Scotland have increased by more than 40% in a five-year period, with the number of Scots aged 16-64 classed as obese up 10% compared to 15 years ago.
With obesity predicted to cost the Scottish economy as much as £3 billion by 2030, advocates of bariatric surgery argue it delivers savings far outstripping the original cost within two or three years. Studies have repeatedly shown around 85% of obese patients with Type II diabetes saw the condition significantly reduced or even eliminated following surgery.
Duff Bruce, surgeon and chairman of the Scottish Complex Obesity Treatment Service, said the surgery will become routine within a generation.
He said: “I would be very surprised if it doesn’t become a routine procedure. I can already feel a shift in attitude towards it throughout all my communications with colleagues, with health boards – it’s become more acceptable.”
However, there is also evidence from the figures that cost pressures may already be putting the squeeze on the two health boards which have led the way in providing weight-loss surgery in Scotland.
In Grampian, procedures are down by 28% compared to three years ago, while Glasgow has seen a fall of 19%. While part of the reduction could be linked to services becoming available in neighbouring health board areas, reducing referrals, Mr Bruce believes the pattern is driven by a process of “rationalisation” likely to be repeated by other health boards as they too expand the service.
Tam Fry, spokesman for the National Obesity Service, said he was concerned health boards were shifting the goal posts on who would qualify for surgery.
He said: “Those that are deserving of surgery should have it. There’s considerable moves on the part of the health boards and primary care trusts down south to up the bar at which point they will offer bariatric surgery, and the reason for that is because they are running out of cash.
“The problem is it’s a false economy because, in the end, they will be paying more to cope with the number of people getting fatter and fatter.”
However, a spokeswoman for NHS Greater Glasgow and Clyde said there had been no change to their bariatric surgery budget.
The figures come as NHS Health Scotland was accused of “tiptoeing” around the problem of childhood obesity by warning health, education and social-care professionals against using the term “obese” or even “overweight” in relation to youngsters, advising them that “unhealthy weight” was more appropriate.
Figures suggest one in three Scottish children aged 13-15 is overweight and one in 10 obese, and one in five primary pupils is overweight.
A spokeswoman for NHS Health Scotland said using the terms overweight and obese could result in parents feeling “blamed or stigmatised”.