YOU don’t have to look too far for authoritative reports that support the notion of bariatric surgery for obese patients. A study published in the journal Public Library of Science Medicine in 2015, for example, found that, when its findings were applied to the 1.4 million morbidly obese Britons, bariatric surgery could prevent 80,000 cases of high blood pressure, 40,000 cases of Type 2 diabetes and 5,000 heart attacks over four years.

Just under a year ago, a study published in the Journal of the American Medical Association said that obese patients who underwent stomach-shrinking surgery had half the risk of death in the following years compared with those who relied on diet and behaviour alone. Experts said that such surgery was cost-effective and led to substantial weight loss.

Scottish figures, revealed today via Freedom of Information requests, disclose that the number of weight-loss operations here fell by a fifth between 2013-14 and 2017-18, from 259 to 205. It has to be said that, in the context of short- or medium-term priorities, the thinking of those who determine local NHS resource allocation can at least be appreciated: bariatric surgery at some £10,00 a time costs the NHS twice as much as a hip or knee replacement, after all, and is around £1,000 more than a heart bypass. But the persuasive rejoinder is that an obese person stands a much-increased chance of requiring one of these procedures over time. Furthermore, obesity is a key avoidable cause of cancer. What we don’t pay now, we will pay later.

Tam Fry, chair of the National Obesity Forum, is correct to observe that current attitudes are a short-term catastrophe. Other European countries recognise the general importance of carrying out many thousands of such operations every year. Here, there is a compelling case to be made that it is better by far to shoulder the cost now than in the ruinously costly years ahead, when competing challenges, such as those posed by an ageing population,will put the NHS under serious strain.