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Half of those with type 2 diabetes showed no sign of the disease a year after weight-loss surgery, says report Surgery to tackle obesity helps to treat a range of diseases, including type 2 diabetes, the first large-scale UK study into weight-loss operations has revealed. It found that after one year, 50% of those affected by diabetes before surgery showed no indication of the disease, with the rate rising to 86% after two years. The National Bariatric Surgery Registry (NBSR) found that the procedures were safe and on average patients lost 58% of excess weight in their first year after surgery. There was also improvement on all associated diseases. The cost of bariatric surgery – which includes gastric bypasses and gastric bands – is recouped within three years as obesity associated costs are eliminated, according to the NBSR. It says there are about 1 million people in the UK who could benefit from bariatric surgery and the NHS could regret limiting treatment. “This data shows that not only is UK bariatric surgery safe, but it successfully treats a whole range of diseases – including the rapid resolution of diabetes – yet commissioners continue to ignore the facts,” said Alberic Fiennes, a bariatric surgeon and chairman of the NBSR data committee. “An approach that limits treatment to a fraction of those who would benefit is one which the NHS will rue in years to come as these patients become an unsustainable burden on the health service.” John Black, president of the Royal College of Surgeons, said bariatric surgery “makes economic as well as clinical sense” and the Department of Health should promote it. “It is a false economy to cut funding for this type of surgery,” he said. “Any short-term savings are tiny compared with the real ongoing cost of treating obese patients.” The report looked at follow-up data for 1,421 operations carried out between 1 April 2008 and 31 March 2010. Of these, 379 patients had type 2 diabetes before surgery, while one year later that figure had fallen to 188. Data from 86 hospitals showed that around two thirds of severely obese patients have three or more associated diseases by the time they reach surgery. Meanwhile, a third have high blood pressure, over a quarter have diabetes and nearly a fifth have high cholesterol. David Stout, the NHS Confederation Primary Care Trust (PCT) Network director, said that while surgery was an important part of dealing with increasing obesity and surgeons were right to measure its efficacy, “the most cost effective solution is to make sure that people do not get to the stage of needing surgery in the first place”. He said: “PCTs need to balance their priorities across a wide range of services, taking into account Nice [National Institute for Health and Clinical Excellence] guidance in the context of local needs. But it is important that all commissioners are transparent in their decision-making.” A DoH spokesman said bariatric surgery should only be considered as a last resort once weight-loss schemes and exercise programmes have been tried. “England has some of the highest rates of obesity in Europe – concerted effort is needed to tackle this,” he said. The spokesman added that the government was encouraging people to make simple changes, such as eating more fruit and vegetables, cutting down on fatty foods and being more active. Obesity Diabetes Health NHS Haroon Siddique guardian.co.uk