A 16-year-old is one of hundreds of Aucklanders who have had recent bariatric weight-loss surgery in public hospitals.
Figures released to the Herald by greater Auckland’s three district health boards show more than 130 people aged under 30 have had bariatric surgery in the past five years.
Those figures include a number of teenagers, although the DHBs withheld the exact number of patients aged under 20 on privacy grounds. Amongst the youngest was a 16-year-old who had the surgery at Middlemore Hospital.
The surgery is much more common among older patients, but the significant number of young people having such a major operation reflects the country’s obesity epidemic.
Bariatric surgery is a treatment for people who are morbidly obese and have been unable to lose weight and keep it off, and particularly if they have other conditions like heart problems. It is also called weight loss or metabolic surgery, and covers a range of operations that restrict the amount of food people can eat, absorb, or both.
Such surgeries are not a “quick fix” or easy option to lose weight. They carry a risk of complications, and need a commitment to lifelong lifestyle changes, including in diet and physical activity.
Public funding for weight-loss surgeries has increased but cannot meet the demand. DHBs use a Ministry of Health scoring system. Patients score more if they have a major obesity-related health problem like diabetes, and if they have failed attempts at weight loss for years. People can be ruled out if they are a smoker or weigh too much.
From 2015-2020, a total of 2068 bariatric surgeries were done across Counties Manukau, Auckland and Waitematā DHBs. Covid-19 disruption affected numbers in 2020 and beyond.
Diabetes Foundation Aotearoa chairman Dr John Baker, an endocrinologist at Middlemore Hospital who led the formation of its diabetes service, said in New Zealand weight-loss surgery wasn’t generally offered to teenagers, for a number of reasons including around consent.
“Generally where the operations are done is when the person has very severe obesity-related co-morbidities – I’m talking about heart failure, advanced liver disease, kidney disease – where there is no other hope,” Baker told the Herald.
“The concern is that there is a lack of services funded by DHBs and the Ministry of Health in the weight-loss area. Bariatric surgery is only for a proportion of people. Otherwise we are looking at nutrition services, weight-loss groups, and so on. And there is just a dearth of those. That is the big issue, I think. There’s no funding for that.”
Counties Manukau had the greatest number of bariatric surgeries completed over the five years, at 913, but declined to make anybody available for interview.
However, in 2017 its specialists Dr Richard Babor and Dr Brandon Orr-Walker spoke to TVNZ about why they were set to start performing a certain weight-loss surgery on obese teenagers.
“I’d rather not be doing surgery on children,” Babor said. “But we do really need to address the quality of our food supply – how we allow big companies to advertise crappy food to children, what kind of food we expose them too – all those kinds of things.”
And in 2018 Babor told the Herald that while weight-loss surgery was a powerful way to help people, it couldn’t alone be used to handle New Zealand’s obesity problem.
“We’d have to have 20 surgeons working 24/7 and the hospitals wouldn’t have space to do any other surgery. So that’s not the answer. Reducing obesity in the population is a political problem … other countries have already banned junk food advertising to children, limited the size of soft drinks or imposed sugar taxes.”
About one in three adult New Zealanders are obese. Rates are higher for Pacific people (63 per cent) and Māori (48 per cent). Nearly 10 per cent of children aged 2-14 years are obese.
Labour has continued National’s preference to work with food and drink manufacturers to try and bring down obesity rates, something that has disappointed public health experts who want much stronger regulation.
Bariatric surgery numbers 2015-2020
Counties Manukau DHB: 913
Waitematā DHB: 640
Auckland DHB: 515
Source: Figures supplied through the Official Information Act
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