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Bulging waistlines threaten to slim taxpayer's wallets

Helen Andrews | 24 April 2014

helen-rittelmeyer Researchers at Monash University are touting the benefits of gastric band surgery for Type 2 diabetics who are merely overweight (body mass index 25-30), not obese (BMI 30+).

The study, published this month in The Lancet, is the first randomised trial to recommend bariatric surgery for this slightly slimmer group. Previous research recommended the surgical option only for the obese (BMI 30-35) and sick, or extremely obese (BMI 35+) and at high risk of becoming sick.

The movement to expand government-funded coverage of bariatric surgeries is gaining momentum in Australia and abroad. We should resist such expansion for two reasons.

First, it is not guaranteed to be cost-effective. A 2013 study by US researchers found that 'bariatric surgery does not reduce overall health care costs in the long term.' After six years, average medical costs were approximately the same for patients who had had the surgery and those who had not.

Professor Paul O'Brien of Monash University and a co-author of the Lancet study has said: 'Bariatric surgery is not about cost-effectiveness. It's about quality of life.' But it is about cost-effectiveness when the dollar in question is the taxpayer's. The more narrowly targeted preventive medicine is, the more likely it is to save money. Expanding eligibility for gastric banding to include the merely overweight would be a move in the opposite direction.

The second reason to resist this trend is that it undercuts the fundamental idea of personal responsibility.

Proponents of bariatric surgery like to describe it as a last-resort measure for when self-control doesn't work. But in the latest Monash study, the control group was made up of patients who received 'standard care,' defined as 'consultations with a doctor every three to six months and sessions with a dietician.'

These are not patients for whom diet and exercise didn't work. At most, these are patients for whom being told to diet and exercise didn't work. We have already begun to speak of people 'having obesity,' as if obesity is a matter of bad luck or a contagious infection. The link between personal behaviour and weight does not need to be severed any further at greater expense to taxpayers.

Helen Rittelmeyer is a Policy Analyst at The Centre for Independent Studies.