Stomach op 'only way to save obese'

By RENEE KIRIONA

Stomach stapling is the only way to save those with life-threatening obesity, and the public should pay for it, says one of New Zealand's leading obesity surgeons.

Iain Martin, of Middlemore Hospital and Auckland University, told the annual meeting of the Australasian College of Surgeons in Auckland yesterday that the Government and district health boards should pay for the surgery, known as gastric bypass or stomach stapling, which costs up to $12,000 an operation.

Mr Martin is a senior lecturer in surgery at Auckland University.

Research by the college has found that surgery is the only way the morbidly obese can effectively manage their weight.

Morbidly obese people are those who weigh more than double their ideal body weight.

Mr Martin said surgery was not the total solution to the country's obesity problem, "but will help the minority of the population who are and will continue to be more of a burden on the health system in the long term if nothing is done now".

Private health insurance companies did not cover the surgery and it was at the discretion of health boards whether they wanted to pay for it, which they rarely did, he said.

Obesity surgeon Richard Stubbs, of Wakefield Hospital in Wellington, said that was because of the perception that obesity was self-inflicted and could be avoided by eating less and exercising more.

"That [perception] is incorrect. Obesity is a societal, political and above all a medical problem - sufferers have a biological problem," he said.

Surgery had achieved results never seen in other methods.

"The average weight of our patients at their first visit is 130kg. Within one year of surgery most patients have reduced to around 80kg and major weight regain after surgery is unusual."

Ministry of Health spokesman Colin Feek said increasing the number of operations was not necessarily the best option as it undermined attempts to solve what he believed was the real problem - poor diet and inadequate exercise.

While both surgeons believed good nutrition and exercise were beneficial for those overweight, it provided no effective solution, and sometimes was too late, for the morbidly obese, they said.

Gastric bypass involves the creation of a small pouch, from which the rest of the stomach is separated.

The small intestine is attached to the new pouch, restricting food intake and reducing the feeling of hunger.

Mr Martin said an estimated 3200 New Zealanders were morbidly obese and only about 100 of them received surgery each year.

Nearly four in 10 New Zealanders are overweight and by 2011 it is predicted a further three in 10 adults will be obese.

Former Labour Prime Minister David Lange and suspended Act MP Donna Awatere Huata both had their stomachs stapled.