BAPRAS to launch new guidelines on body contouring

Members of BAPRAS have been caring for patients with severe obesity, the problems associated with this disease and the sequelae of treatment for some time. Severe obesity is a complex disease process of modern society – the cause is part genetic and part environmental.

We view the problems obese people face seriously. About one third of all adults in the UK are obese. The long term care of the obese costs the state billions of pounds.  Heart attacks, strokes, diabetes, wear and tear of joints leading to joint replacement surgery, gall bladder disease, cancer risk are all more common in the obese.

Safe bariatric surgery has made it possible to effectively treat obesity. The resultant weight loss  dramatically improves the health of each individual, and saves the state billions of pounds. This has however not returned the patient to a fully healthy state. The Sun recently carried an article about a woman who had experienced bariatric surgery and subsequently massive weight loss. The patient was left with a large amount of excess skin and was calling for more access to body contouring surgery on the NHS.

The World Health Organisation defines health as ‘…complete physical, mental, and social well being…’  The woman mentioned in the article appeared extremely distressed by the way her body has changed after massive weight loss. She may have a healthier body with less risk of heart disease and diabetes, but her mental health has suffered because of what she has become with the weight loss – infections in the folds of skin, unable to find clothes that fit, difficulties doing most exercises, low self esteem, poorly performing at work because of psychological stress, mental depression not far away – this is her current life – not really very healthy. So, should we stop with her treatment after her weight loss? With limited funds available for the NHS, this is where it ends for most patients. They are left to live lives unhappy with the partial treatment that has been provided. The same goes for people who laboured to lose the weight naturally.

But there is a way to improve all this – reconstructive body contouring surgery – we as a professional organisation would support this on the NHS in many cases. A survey carried out by BAPRAS in 2011 revealed that 45% of GPs would too. This surgery gives these people a new start, and allows them to re-enter society as contributing individuals, happy with their new health, function, and body appearance – all the evidence points to significant quality of life improvement. Leading productive fulfilled lives, they are able to contribute to society.

This surgery does cost money – but this really needs to be compared with the costs of obesity to the State. In comparison, the cost of bariatric surgery and subsequent body contouring surgery is a drop in the ocean. Should the tax payer pay for such surgery on the NHS? In many cases yes, and to ensure resources are distributed fairly and appropriately, BAPRAS is working to produce guidelines which it hopes the NHS will use when considering who will be eligible for this ‘body contouring’ surgery. We are currently working with expert groups, specialist surgery societies, charities and colleagues from England, Scotland and Wales to ensure these guidelines are appropriate and can be easily implemented across Britain.

I look forward to sharing more details of these guidelines in 2013. Until then, if you would like more information, would like to input or want to share any personal stories on this matter, please contact our communications team by emailingvoice@bapras.org.uk

Mark Soldin, MBChB, FCS(SA)Plast, FRCS(Plast)
Consultant Plastic, Reconstructive and Aesthetic Surgeon, Full Member of BAPRAS