Best supportive care for patients with complex obesity
Phillips, Simon Sudlow, Alexis Arvind, Nitin Hewes, Jim Hopkins, James Le Roux, Carel Pournaras, Dimitrios
Phillips, Simon
Sudlow, Alexis
Arvind, Nitin
Hewes, Jim
Hopkins, James
Le Roux, Carel
Pournaras, Dimitrios
Glos Author
Date
2023-07-28
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Abstract
Background Surgery remains the most effective treatment for obesity, however it may not be available, acceptable, or appropriate for a significant proportion of patients. Effective alternatives to surgery were previously limited and did not provide comparable outcomes in most patients, this has changed recently. There is no readily available data on the number of patients referred to Tier 3 and 4 weight management services in England and Wales, or what proportion of those referred undergo surgery. With approval of effective pharmacotherapy to be used in weight management services in the UK it is important to understand how many patients could stand to benefit from multimodal treatment. Objectives Identify the group of patients who do not receive bariatric surgery following referral to a tertiary bariatric service in the UK. Highlight the potential for undertreatment of obesity in these patients.
Methods Single centre analysis of prospectively collected data to identify patients referred to a tertiary bariatric service over a six-year period (April 2010-December 2016).
Results 1266 patients were referred to the bariatric service. 4 were excluded due to missing data. 604 patients (47.8%) received laparoscopic bariatric surgery and 34 (2.7%) an intragastric balloon. 624 patients (49.4%) had no surgical or endoscopic intervention.
Conclusions Almost half of patients referred did not receive surgical or endoscopic treatment, representing a significant number who should be considered for alternative treatment modalities. With the increasing availability of effective pharmacotherapy and endoscopic treatments, there is a growing opportunity for weight management MDTs to adopt the model of care established within cancer services, providing best supportive treatment to those not having surgery. We have a duty of care to provide for patients referred to weight management services, including those who do not undergo surgery.
Citation
Phillips S., Sudlow A., Old O., Arvind N., Hewes J., Hopkins J., Pournaras D. (2023). Best supportive care for patients with complex obesity. Obesity Surgery, 33(Supplement 2), 53-54. https://doi.org/10.1007/11695.1708-0428