Bariatric surgery: BAPRAS response

Dear Sir

Mark Porter is correct to raise concerns over the small number of bariatric surgeries performed in the UK (Weight-loss surgery is expensive but can be the only solution for some, 23 October), but equal attention needs to be paid to the even fewer surgeries performed to remove excess skin after the weight loss.

Massive weight loss leaves many patients with unwanted folds of hanging tissue, causing a range of health and psychological problems if left without surgical treatment. About one third of all adults in the UK are obese and it is thought that between 25-50% of patients who experience massive weight loss would benefit from body contouring surgery, though few patients can access this treatment on the NHS.

Yes this surgery costs money, but it really needs to be compared with the cost of obesity to the state, which is 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.

The bariatric surgery patient pathway often requires reconstructive body contouring and this needs to be factored into the investment. Research has shown a significant improvement in life quality after massive weight loss body contouring.

The British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) is working closely with interested parties to create equity for patients across the country and we are formulating much needed national guidance on massive weight loss body contouring in order to enhance the physical and emotional health of patients across the UK.

Yours faithfully
Mark Soldin, Consultant Plastic, Reconstructive and Aesthetic Surgeon
British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)