Inequalities in bariatric surgery in Australia: findings from 49 364 obese participants in a prospective cohort study

10 Dec 2012

This article investigates the variation, and quantify socioeconomic inequalities, in the uptake of primary bariatric surgery in an obese population in Australia.
Obesity is a major public health challenge for Australia. In the 2007–08 National Health Survey, 24% of Australian adults were reported to be obese and a further 37% overweight. Obesity rates are growing and the continuing increase in severe obesity is of particular concern. It is a major risk factor for type 2 diabetes and a range of other chronic diseases, including cardiovascular, digestive and musculoskeletal disorders, as well as overall mortality.5 Clinical guidelines recommend bariatric surgery for those with a body mass index (BMI) over 40 kg/m2, or BMI over 35 kg/m2 and comorbid conditions, after non-surgical options have failed.
This surgery is more effective than non-surgical interventions for the treatment of severe obesity, and it is cost-effective. In addition to substantial weight loss, bariatric surgery can lead to improvements in comorbid conditions including lipid abnormalities, obstructive sleep apnoea and joint disease.8-11 Of particular note is its effectiveness in treating type 2 diabetes, with one recent trial showing remission rates of 75%–95% within 2 years after surgery.
*Other authors - Grace Joshy, Louisa R Jorm, James RG Butler and Emily Banks

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