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    The efficacy of bariatric surgery performed in the public sector for obese patients with comorbid conditions

    240649_240649.pdf (212.0Kb)
    Access Status
    Open access
    Authors
    Lukas, N.
    Franklin, J.
    Lee, Crystal
    Taylor, C.
    Martin, D.
    Kormas, N.
    Caterson, I.
    Markovic, T.
    Date
    2014
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Lukas, N. and Franklin, J. and Lee, C. and Taylor, C. and Martin, D. and Kormas, N. and Caterson, I. et al. 2014. The efficacy of bariatric surgery performed in the public sector for obese patients with comorbid conditions. Medical Journal of Australia. 201 (4): pp. 218-222. © Copyright 2014. The Medical Journal of Australia - reproduced with permission.
    Source Title
    Medical Journal of Australia
    DOI
    10.5694/mja13.00046
    ISSN
    0025-729X
    School
    School of Public Health
    URI
    http://hdl.handle.net/20.500.11937/25387
    Collection
    • Curtin Research Publications
    Abstract

    Objective: To determine the effi cacy of bariatric surgery in the public sector for the treatment of complicated obesity. Design, setting and participants: A longitudinal observational study of obese participants with comorbid conditions, aged 21-73 years, who underwent publicly funded bariatric surgery. Data were extracted from clinical databases (1 October 2009 to 1 September 2013) and recorded at seven time points. Participants are from an ongoing public obesity program. Main outcome measures: Postoperative weight loss and partial or full resolution of: type 2 diabetes mellitus (T2DM), hypertension (HTN), dyslipidaemia and obstructive sleep apnoea (OSA). Results: The 65 participants in the cohort lost a mean weight of 22.6 kg (SD, 9.5 kg) by 3 months, 34.2.kg (SD, 20.1 kg) by 12 months and 39.9 kg (SD, 31.4 kg) by 24 months (P < 0.001). Body mass index (BMI) decreased from a preoperative mean of 48.2 kg/m<sup>2</sup> (SD, 9.5 kg/m<sup>2</sup>) to 35.7 kg/m<sup>2</sup> (SD, 7.7 kg/m<sup>2</sup>) by 24 months (P < 0.001). Full resolution of comorbid conditions by 18 months (P < 0.001) was achieved by almost half of those with baseline T2DM, nearly two-thirds with HTN and three-quarters of those with OSA, with continued improvements beyond 24 months. Conclusions: Bariatric surgery performed in the public sector is efficacious in the treatment of obese patients with comorbid conditions. Our findings parallel similar studies suggesting that there is equal benefit in publicly funded and privately performed procedures. This study highlights that obese patients reliant on public health care maintain sufficient intrinsic motivation in the absence of payment and supposed value-driven incentive. Improved access to bariatric surgery in the public sector can justifiably reduce the health inequities for those most in need.

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