Long-Term Outcomes of Obesity Surgery and Implications for Health System Planning

Weight loss surgery is currently the only treatment that offers significant and sustained weight loss for those with severe and complex obesity. Obesity levels have reached a sustained high, whereby several percent of a country's population would qualify for surgery based upon current national guidelines. Worldwide, the provision of surgery is highly variable and to treat all the affected population, it would require at least a 100-fold increase in the provision of services. This has important cost and commissioning implications for health-care planners. Reliable level 1 evidence of the long-term effects of obesity surgery is still lacking, and the long-term complication profiles and re-operation rates unclear, which could have significant impact on health-care systems in the future. The chronic disease management of obesity in a population must be integrated with education and prevention and the brief intervention of weight loss surgery and the management of its sequelae, to prevent significant future morbidity and mortality.