Severe obesity is on the rise in epidemic proportions throughout the world, and Canada has not been spared. Obesity is recognized as a chronic disease with several associated disorders. According to the World Health Organization (WHO), over 1 billion people are overweight, about 300 million have class 1 or 2 obesity, and 30 million can be classified as morbidly obese. For patients with morbid obesity, the only solution for permanent treatment is bariatric surgery. However, access to such operations is very limited in Canada.
|Province||Procedures covered by health insurance||Estimated waiting time at public facilities|
|Alberta||Gastric Sleeve Surgery|
Gastric Bypass Surgery
|6 to 10 years|
|British Columbia||Gastric Sleeve|
|4 to 5+ years|
|New Brunswick||Gastric Sleeve|
Gastric Band (all types covered, but not all are performed in the province)
|3 to 5 years|
|Newfoundland and Labrador (no surgeons listed)||Gastric Sleeve|
|Nova Scotia (no surgeons listed)||Gastric Sleeve||3 to 5 years|
|Initial appointment: 6 months to 1 year|
Surgery: 2 to 3 years
|Prince Edward Island (no surgeons listed)||Gastric Sleeve|
Gastric Bypass (covered, but performed out of province)
|3 to 15 years|
Why Not Just Lose the Weight Naturally?
There is no dispute that an obese patient can slowly lose the weight through proper diet and exercise. The challenge will maintain the weight loss long term. The only way that obesity and its related diseases can be kept at bay is not just by losing weight but maintaining it. Furthermore, according to a study conducted, permanent weight loss through bariatric surgery reduces the risk of death from 35% to 89%. To be eligible for bariatric surgery, a patient must have a BMI of 40 or one of 35-40 and already suffer from obesity-related conditions such as diabetes.
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Why is it so difficult to have the surgery in Canada?
It is quite challenging to access bariatric surgery in Canada. Very few resources such as money and equipment are made available to treat this condition. Some provinces go as far a not even recognizing obesity as a service to be insured in their healthcare plans. Moreover, those that do consider the disease as insurable have problems providing timely access to patients for a host of reasons.
With so many patients needing the surgery and so few resources, this creates a backlog of patients waiting for the operation. It is estimated that it can take an average of 5 years for patients to get a bariatric surgery done and in some cases, it takes eight years. Research from three of the most significant bariatric surgery centers in Quebec showed a bottle-neck approach when dealing with patients requiring bariatric surgeries. As patients received their surgeries and left the waiting list, others were moved forward according to their scheme. This results in about five stages of waiting for bottlenecks. The bottle-neck procedure consists of:
1. Office consultation request
2. Bariatric questionnaire and surgery information kit sent to patients
3. Information received, and patients screened, waiting to see a bariatric surgeon
4. Patients evaluated by surgeon and surgery approved
5. Surgery performed
When considering waiting times for any form of surgery, it is essential to specify what exactly is waiting time. When exactly does a patient enter the queue and at what part of the queue is the agreed-upon waiting time? According to definitions of waiting times, the waiting time for surgery starts when a request for admission is submitted by the surgeon’s office to the office that accepts admissions in the hospital. This definition, however, does not bode well when defining waiting time for bariatric surgeries. This is best defined as the time it takes to cover process 1-5 as shown above.
The saddest part of all this is that some patients die while waiting to undergo bariatric surgery. Assuming that 2-4% of the Canadian adult population is morbidly obese, an estimate of those requiring bariatric surgery is about 600 thousand to 1.2 million. Only about 150-250 bariatric operations a year were conducted in the most important hospitals in Canada. If resources are not pumped into combating the obesity issue in Canada, this situation is set to worsen as obesity is on the rise. Furthermore, the longer patients are left untreated, the more likely their chances to develop even more complications and related conditions.
Studies demonstrate just how long the waiting period for Bariatric surgeries in Canada is, averaging at five years. When this is compared to the Fraser Institute and the Wait Times Alliance, reasonable surgery wait times are 18 months for cosmetic surgery and eight weeks for cancer surgery. The inappropriate wait time system for bariatric surgery in Canada stems from a lack of capacity in Canadian health centers and hospitals.
With all the problems a prolonged waiting time for bariatric surgeries comes with, it is safe to say that something needs to change. For those that are currently morbidly obese, there is no harm in trying out other avenues for weight loss as a solution is sought. A lifestyle of healthy eating and an active lifestyle will go a long way in trying to manage these conditions and even prevent them in the long term.