NSW to fund weight loss surgery

[visitor1]

THE NSW government will pay for weight-loss surgery for morbidly obese people in a radical attempt to slash the $7 billion burden of obesity in NSW.
Fairfax says more than 8000 lap-banding surgeries are conducted in Australia each year, but 95 per cent are done in private hospitals.

It says a policy to fund such operations in public hospitals will be unveiled tomorrow as part of a strategy aimed at the 51.7 per cent of adults who are overweight or obese.

Health Minister Reba Meagher is also expected to announce the establishment of one-stop clinics to tackle obesity-related conditions such as diabetes, kidney failure and heart disease.

Patients with a body mass index of 30 or more can be referred by their GP to the clinics, which will have access to specialist physicians, diabetes nurses, dietitians, psychologists and exercise physiologists.

At least 1.13 million people in NSW are obese, with that number predicted to grow by about 15,000 people a year.

Professor of human nutrition at the University of Sydney Ian Caterson said this kind of multi-disciplinary approach is needed if the state is going to beat the obesity epidemic.

"We don't have anything that's logical and connected, and to tackle obesity you need to be able to go somewhere which has all the modern treatments, and that includes bariatric surgery," said Professor Caterson, who is among the public health experts drafted into the university's new Centre for Physical Activity, Nutrition and Obesity Research.

The experts will advise Ms Meagher on how to reverse our expanding waistlines, including reducing childhood obesity rates to 22 per cent by 2016.

Lap-banding involves keyhole surgery to insert a band around the top of the stomach, so patients eat less. It is considered a relatively safe and cost-effective way to reduce obesity-related conditions such as heart disease, diabetes and cancer.

A Monash University study found obese patients who had gastric bands fitted were five times more likely to be free of diabetes than patients trying diet and exercise.

But the potentially life-saving option has been largely out of reach for those without private health insurance or able to pay $10,000.

Thought this was interesting....now if only i was still in NSW!
It seems surgery is becoming more common as is the obese population. Speaking from some one who is a huge fat @ss its good to see some help being granted.

[Neenee Jellybeanie]

The waiting list in public hospitals for elective surgery is long already, how will public hospitals cope with this?

I think this is a great initiative but it's not a complete solution. Instead of funding surgery, why doesn't the government fund personal trainers first? Or make access to dieticians easier? (I saw a dietician as a teenager in a public hospital but I don't know if that's available in all states or if it's available at all for people over 18).

[BellyBelly]

Just a side comment - its amazing how governments are so happily and easily granting this sort of stuff when they have so much trouble trying to ease our overloaded maternity systems without funding private midwives, saving many thousands of dollars - they could do many more of these surgeries if they did. Private midwife = $4 approx. Hospital = $13-24k.

[C~Q]

I'm sorry but I think this is another way of turning us in to a nation of people absolved of all responsibility for their actions. I agree with babysocks, fund PT's and Dieticians, have free "boot camp" type situations or even government funded gyms.

When I heard that Australia had taken over America and we are now the most overweight nation in the world I couldn't believe it and it's happening to more and more children as well. What sort of message are we sending to our children? "It doesn't matter if you don't eat right and exercise, you can always have surgery"

I was told on my course that Drs aren't calling Type 2 Diabetes "Adult onset Diabetes" anymore as more and more children are diagnosed with it.

[thepixie]

When I heard that Australia had taken over America and we are now the most overweight nation in the world I couldn't believe it and it's happening to more and more children as well.

The survey which was promoted in the media as showing that Australia has higher rates of obesity than America was actually hopelessly flawed. It was based on people aged 45-60 who presented for free blood pressure testing. As high blood pressure is often associated with obesity the sample were self-selecting to be overweight or obese. The scientific validity of this study across the whole population of Australia was effectively nil.

[/QUOTE]What sort of message are we sending to our children? "It doesn't matter if you don't eat right and exercise, you can always have surgery"
[/QUOTE]

We are sending some very twisted messages to our children. We are teaching them that all that matters is how you look. As long as you look like some emaciated waif on the cover of a magazine who probably lives on cocaine and cigarettes, well that's fine. People can be active and eat healthy and still be on the heavy side. But we promote this Kate Moss ideal like it's healthy. If we want people to be healthy we should stop focusing on how they look and promote healthy eating and exercise. We should stop judging people by BMI (a worthless measure) and start judging ourselves on how healthy we are.

Is the government going to fund treatment for anorexia? because all this focus on body size especially in young people is likely to start an epidemic. And anorexia is a deadly mental illness with a mortality rate of 20% affecting young women almost exclusively.

I sympathise with those who feel they need this surgery but I agree with Kelly that it's far from what should be the government's first priority.

[C~Q]

We are sending some very twisted messages to our children. We are teaching them that all that matters is how you look. As long as you look like some emaciated waif on the cover of a magazine who probably lives on cocaine and cigarettes, well that's fine. People can be active and eat healthy and still be on the heavy side. But we promote this Kate Moss ideal like it's healthy. If we want people to be healthy we should stop focusing on how they look and promote healthy eating and exercise. We should stop judging people by BMI (a worthless measure) and start judging ourselves on how healthy we are.

Are you talking about the subject at hand or are you talking about the media/Aus as a whole when you say "We"?

Of course people can be on the heavy side and still be healthy, but those aren't the people that are getting the surgery. And there is no way that you can tell me that someone who is classed as able to get the surgery is "healthy". No one is saying you either have to look like Kate Moss or be Obese.

As for BMI, it is not worthless. It's a screening tool used in conjunction with other tests to give you an IDEA of somebodies body composition. It is in no way totally acurate and it will overestimate body fat in someone who is very muscualar and underestimate body fat in older people who have lost muscle mass.

I don't believe that any Dr/fitness instructor etc uses BMI alone.

What we need to be teaching, and by that I mean showing by example, our children is how to eat a healthy, balanced diet and how to exercise and have fun. If you have a parent who drags themselves to the gym and moans about it then you're teaching that exercise is boring. If more familes get outside, go to the park, go on bikerides etc together then we could be solving all the problems in one go.

[thepixie]

Are you talking about the subject at hand or are you talking about the media/Aus as a whole when you say "We"?

This was a more generalised comment about our cultural approach to weight, diet and health.

Sure in Australia it seems at the moment that the surgery is restricted to those who seem to really need it. The trend in the States is a bit different though, and that is a worry. Not something I would want to see happen here.

[/QUOTE]I don't believe that any Dr/fitness instructor etc uses BMI alone.[/QUOTE]

Possibly not - but people certainly use it to judge themselves. And when we have teenage girls using such a crude measure to judge the appropriateness of their body weight I personally feel that we are creating a problem. But then I have a twelve year old sister so I am probably biased about this.

RachelM I really don't think we disagree. I think there needs to be more of a focus on genuine health, which means eating healthy whole food and being active.

I personally don't feel that funding obesity surgery should be the government's first health priority given the other problems already existing in the health system. That's just my opinion.

[Rouge]

I don't agree with this at all.

I would rather see a ban a tax on junk food (to be reabsorbed by making healthy foods cheaper) than I would seeing this. Or better yet take on what some city's in the world are doing and ban fast food chains.

Those operations aren't cheap, and I think the money could be better spent elsewhere especially given so many other areas are in dire need.

And FYI I'm a goddessly sized girl so I'm not having a go at anyone's size etc.

I agree with society's need to change, but some days I really do wonder if we are getting too PC. Like the clothing chain "Big City Chick" recently removed "Big" from their name! I mean C'MON surely people look in the mirror, I am big its not offensive its the bloody truth! People should get over themselves, seriously. Maybe if we stopped tip toeing around the issue people wouldn't be sitting around thinking they didn't have a problem.

[C~Q]

seriously. Maybe if we stopped tip toeing around the issue people wouldn't be sitting around thinking they didn't have a problem.

Exactly! And Pixie is right, it's not about the way people look. Heart disease, Diabetes etc can affect people of all sizes. It's what you eat and the exercise you do. Just because you happen to be blessed with a superfast metabolism doesn't mean you can eat junk and sit on your bum and not be affected by these diseases.

I would say people need to be better educated about food, portion sizes, nutrition etc but honestly the info is all out there and it is readily available. Who doesn't know that a Whopper with cheese and bacon and a large coke isn't good for you?!!

[TheBear]

Rachel - BMI is a totally worthless screening tool - the fact that it has been seized upon by the government as primary test for public health care decisions is irresponsible.

BMI attempts to use height and weight to estimate body fat percentages, on the assumption that increased weight correlates to increased body fat. However there are numerous studies that shows that this is not a valid correlation.

As you point out not only does the BMI indicate that muscular, fit healthy people are obese, it also indicates that those that are malnourished to the point of muscle wastage are in the normal category. There are plenty of other measures and indicators that are considerably more accurate and simple to use.

I totally agree on on teaching by example, but I do have an issue with the amount of health education that is focusing on BMI based estimates of health to the detriment of the rest of the whole lifestyle/nutrition/exercise issue.

Many medics will provide referrals to available public treatments if they can, without really considering if it is in the broader best interests of the patient - they know that if it is what the patient wants then they will find another GP that is willing to refer them and go elsewhere. Our family is full of medics, this happens a lot with many different health issues.

If the health minister is able to stand up and announce that this is NSW's answer to tackling obesity then it will allow the focus on all the other, more politically challenging, aspects of the problem to be put on the back burner.

Sure, most people know that a Whopper Meal isn't an ideal part of a balanced diet, do they know how bad the "diet" products in the stores are? There is a strong case for much better public education about diet and nutrition, but there are some very powerful food businesses that are lobbying against it - many of these are not obviously in the 'junk' food business.

[C~Q]

I can't speak for the medical community but I am studying to become a personal trainer and I know that we (in the fitness industry) have been taught to use BMI in conjunction with at least 3 other body composition tests ie Waist to Hip ratio, skinfold measurements and % body fat using bioelectrical impedance. None of these by themselves are completely accurate, hell, none of them together are completely accurate but body compostion is a hard thing to determine.

I really don't understand why this thread has become an attack on BMI? Are you saying that because there is no accurate way of determining who is "Obese" and who isn't then it doesn't exist? We should all bury our heads in the sand?

There are two main factors here and I don't think anyone is disagreeing with this...diet and exercise. I agree that food companies should be more open about there products and what 'low fat' and 'diet' really mean but people also have to take responsibility and find out for themsleves.

Some of the information we were given when we touched on Nutrition last weekend was shocking to say the least. We all left the college shaking our heads wondering if it was at all possible to have a balanced diet from the food that is made available to us, the public. The worst being that a huge amount of the fruit and veg we buy in the supermarket and most independant shops can be up to 3 years old with barely any nutritious value at all - and whats left is destroyed upon cooking.

*shakes head* I don't know what the answer is but when you look at the statistics you know that something has to be done or the cost on our health system is going to be huge in the future.

[thepixie]

The article says "Patients with a body mass index of 30 or more can be referred by their GP to the clinics, which will have access to specialist physicians, diabetes nurses, dietitians, psychologists and exercise physiologists."
So BMI is going to be used as a threshold criterion for evaluating who is eligible for surgery.I took this to suggest it was being used as a measure of public health and for that purpose I think it is pretty flawed. Easy to measure across large populations perhaps, but flawed nonetheless. I think that might be how we detoured into a discussion of BMI.... woops.
And RachelM you're right, the nutritional value of many people's diet is just scary. But is the right solution to that to use government money to surgically modify people so they don't show the physical effects of the terrible diet? There's got to be a better way.

[Nai]

I would rather see a ban a tax on junk food (to be reabsorbed by making healthy foods cheaper) than I would seeing this.

I agree Cai - I would also like to see PE reintroduced as a daily activity for primary schools and Home Economics in secondary schools to teach kids about healthy choices and how to cook fresh food.

I would prefer to see a more holistic approach from the government rather than just funding surgery. I have seen a number of people go through this surgery however the outcomes have never been what you would call succeessful in the long term.

I really think the focus should be on health and long term sustainable lifestyles combined with approprite messages and education.

[Neenee Jellybeanie]

Some of the information we were given when we touched on Nutrition last weekend was shocking to say the least. We all left the college shaking our heads wondering if it was at all possible to have a balanced diet from the food that is made available to us, the public. The worst being that a huge amount of the fruit and veg we buy in the supermarket and most independant shops can be up to 3 years old with barely any nutritious value at all - and whats left is destroyed upon cooking.

Whaaaaaaaaaaaaaaaaaat the heck?!

[C~Q]

Thats pretty much what we said! She told us to always ask if the fruit and veg was this years season - even at a Farmers Market, it's scary. She said if you weren't sure then frozen veggies were best but RAW(!) fresh veggies were best.

I think Nai's ideas are great. I couldn't believe it when I found out that kids didn't do PE every day. And HE in senior school would be fantastic.

Perhaps the government is just emabarrassed with Australias new "fattest nation" tag and it just wants to fix the problem the quickest way possible...

[TheBear]

Food Provenance will hopefully become a hot topic soon - in the same way that retailers have to disclose ingredients now, it would be great for them to display the complete history of the item - growth, harvest, storage, treatment just so that you can actually know what you are eating and make better choices. Even the organic certifications usually only have requirements pre-harvest at present.

We buy all of our fresh produce at Farmer's Markets, most of the stalls can provide this sort of history for their products - only one of the stalls tries to sell imported/stored produce and it is avoided by regular visitors to the market. Try asking the same sort of questions in your supermarket and see what sort of response you get.

Nai's ideas are spot on, but with school funding cut to the bone already these non-core academic areas of education are likely to continue to be neglected for some time.

[C~Q]

Nai's ideas are spot on, but with school funding cut to the bone already these non-core academic areas of education are likely to continue to be neglected for some time.

That's just so crazy...and sad. If we can educate people early enough then we could save ourselves so much money in the future Perhaps something extra run by the P&C using volunteers? Perfect world, I know...

ETA - I think i'm going to start another topic on Nutrition.

[visitor1]

I would also like to see PE reintroduced as a daily activity for primary schools and Home Economics in secondary schools to teach kids about healthy choices and how to cook fresh food.

When i was in primary school (hmm some 20 years ago now when i started) we had 30 mins of physical exercise every morning. Whether it be dancing, skipping with rope, jogs, a game of something etc.....it was a morning MUST. Plus we had sport day on top. Our canteen never sold one piece of junk food!

HS was a different matter...was the complete opposite....junk food galore, sport day was a hit and miss event and PE classes were so easy to get out of!