Volume 199 - Issue 4
Inequalities in bariatric surgery in Australia: findings from 49 364 obese participants in a prospective cohort study
Authors: Alessandra Doolan and Anne Trimmer
Med J Aust 2013; 199 (4): 240-241. || doi: 10.5694/mja13.10462
Published online: 2 September 2013
Published online: 2 September 2013
With the growing prevalence of obesity (including morbid obesity) in Australia, especially in those living in areas of lower socioeconomic status, improving access should be a priority health commitment.
To the Editor: On behalf of the Medical Technology Association of Australia, we would like to commend the findings of Korda and colleagues on the inequalities in patient access to bariatric surgery in Australia.1
One issue that can be identified in the study is the inclusion of individuals with body mass index (BMI) in the range of 30–34 kg/m2. It is clinically accepted worldwide that individuals with BMI ≥ 30 kg/m2 are classified as obese. However, according to Australian clinical guidelines and other clinical guidelines, bariatric surgery is recommended for individuals with morbid obesity (BMI ≥ 40 kg/m2) or with BMI 35–40 kg/m2 and comorbid conditions.2,3 Therefore, including only those individuals considered to “need” bariatric surgery would allow for more accurate findings in showing inequalities in patient access to bariatric surgery.
We agree with the finding that bariatric surgery is mostly taken up by those who have private health insurance and who can afford the out-of-pocket costs associated with the procedure.4 In the past decade, there has been a significant increase Australia-wide in the number of bariatric surgeries performed, which is in line with the sharp increase in the prevalence of obesity (and morbid obesity) in recent years in Australia.5
The study by Korda and colleagues highlights the presence of inequalities in patient access to bariatric surgery. With the growing prevalence of obesity (including morbid obesity) in Australia, especially in those living in areas of lower socioeconomic status, improving access should be a priority health commitment.6
Competing interests
The Medical Technology Association of Australia represents the manufacturers, exporters and suppliers of medical technology products in Australia. The range of devices includes those that can be used for bariatric surgery.
References
- Korda RJ, Joshy G, Jorm LR, et al. Inequalities in bariatric surgery in Australia: findings from 49 364 obese participants in a prospective cohort study. Med J Aust 2012; 197: 631-636. 0_BABEAIAG
- National Health and Medical Research Council. Clinical practice guidelines for the management of overweight and obesity in adults. http://www.health.gov.au/internet/main/publishing.nsf/Content/obesityguidelines-guidelines-adults.htm (accessed Mar 2013).
- National Heart, Lung and Blood Institute. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. http://www.nhlbi.nih.gov/guidelines/obesity (accessed Mar 2013).
- Australian Institute of Health and Welfare. Weight loss surgery in Australia. Canberra: AIHW, 2010. (AIHW Cat. No. HSE 91.) http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442472773 (accessed Mar 2013).
- Australian Institute of Health and Welfare. Overweight and obesity. http://www.aihw.gov.au/overweight-and-obesity (accessed Mar 2013).
- Australian Institute of Health and Welfare. Risk factors for cardiovascular disease, type 2 diabetes and chronic kidney disease. http://www.aihw.gov.au/cardiovascular-health/risk-factors (accessed Mar 2013).