An Irish bariatric surgeon says weight loss surgery is still very stigmatized in Ireland, with fewer men than women opting for the procedure.
Illiam Robb, who performs between 60 and 100 bariatric surgeries at Blackrock Clinic each year, thinks obesity is a misunderstood disease.
In the public system, the number of surgeries performed at St Vincent’s Hospital from 2018-2020 was in the high 70’s, although due to the pandemic it fell to 17 in 2021, while there is also a smaller number performed in the University Hospital Galway.
Mr Robb said bariatric surgery has been chronically underserved in the public health system in Ireland for decades.
“For a population like Ireland and the amount of obesity we have, we probably need to do 2,000 or more than 2,000 of these surgeries a year. The reality is that in our public health system, it’s well below the numbers needed to address the problem,” he said.
“Changes are planned. There is a national implementation plan that will hopefully include the appointment of more public obesity management consultants and public obesity management surgeons.
“We definitely need to see much higher access to this type of surgical treatment in our public hospitals.
“In my experience, more women access it than men. Males are probably less likely to report. That’s probably something we need to change as well.”
He said the most satisfying part of this type of surgery is the radical change in patients’ lives.
“They can really get active and do sports and activities that they never dreamed of doing before the surgery.
“They are able to do things and engage in things that they might not be able to do for decades of their lives.”
In a recent statement, the HSE said it will provide funding this year to “improve access and capacity to specialist services, including bariatric surgery, nationally, providing specialist care in the right place at the right time, reducing wait times and the development of services at the national level”.
With long waiting lists, some Irish patients have flown abroad to have the surgery, but Mr Robb said patients are often unaware they could qualify for the procedure through their health insurance in Ireland.
“There are fairly well-established international criteria for the appropriateness of surgery, and health insurance companies have similar criteria for qualifying patients,” he said.
“That’s really number one, if patients have a body mass index over 40 or if their body mass index is over 35 and they have significant illnesses and complications due to their weight and obesity, then surgery can be done in be considered.
“We still find patients with private health insurance who travel abroad not knowing that they would be covered by their private health insurance to have treatment done at home.”
He has seen mixed reports from patients who have had the surgery abroad and said the procedure is still stigmatized.
“I see patients who come back with good stories, but I also see patients who come back with problems.
“I work at both Beaumont Hospital and Blackrock and from time to time we see patients who come through our ER who have had surgery abroad and have a complication or problem.
“People are ashamed of their weight. There is a culture of “it’s their fault”. Science and everything else is telling us more and more that weight and obesity is not the patient’s fault and we need to destigmatize it.”
The surgeon expects up to 150 surgeries next year.
“Most patients, on average, can expect to lose about 70 to 75 percent of their excess weight within a year to 18 months,” he said. “Patients who come to us can be overweight by 15 or 20 stone, and if you are overweight by 20 stone, yoYou could lose 15 stones. It’s life changing.”
https://www.independent.ie/irish-news/health/we-need-to-see-a-much-higher-level-of-access-experts-fighting-stigma-around-obesity-surgery-41515100.html ‘We need much higher access’ – Experts fight stigma around obesity surgery