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Bariatric surgery numbers up significantly in Canada but annual figures still low

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BAriatric surgeries in Canada

TORONTO - The number of bariatric surgeries performed on obese Canadians rose by 300 per cent in recent years, a new report suggests.

While the size of that increase seems enormous, the reality is that the number of surgeries at the start of the study period — 1,600 — was low. And even after the 300 per cent increase, the number of these surgeries performed in 2012-2013 across the entire country was 6,000, obesity expert Dr. Yoni Freedhoff noted.

With one million Canadians meeting the eligibility criteria for bariatric surgery, the number of surgeries performed is a drop in the bucket. And Freedhoff suggested that while the surgery counts will continue to rise, bariatric surgeries cannot solve the country's obesity problem.

"We clearly will never have the capacity in Canada to help all of those who would qualify for bariatric surgery with bariatric surgery," say Freedhoff, an assistant professor of family medicine at the University of Ottawa and founder of Ottawa's Bariatric Medical Institute, a nutrition and weight management centre.

"We are not going to cut this problem away."

The figures were contained in a report on bariatric surgeries released Thursday by the Canadian Institute for Health Information. It covers the seven-year period from 2006-2007 to 2012-2013.

The report only captures surgeries performed by provincial health-care programs. So gastric bypass surgeries that were paid for by individuals or which were done outside of Canada would not be included.

Figures on three main types of gastric surgeries were included in the report: gastric bypass, where the size of the stomach is reduced and part of the small intestine is bypassed; sleeve gastrectomy, where 80 to 85 per cent of the stomach is removed; and adjustable gastric banding, where a band is placed around the upper portion of the stomach, limiting its capacity. Of the three, gastric bypass is the most commonly performed.

Most of the increase in procedures occurred in Ontario, which went from 297 operations at the beginning of the study period to 2,846 in 2012-2013.

In fact, about 80 per cent of the 2012-2013 surgeries were performed in Ontario and Quebec. The provinces with the highest obesity rates — the four Atlantic provinces, Manitoba and Saskatchewan — performed less than eight per cent of the bariatric surgeries recorded in Canada in 2012-2013.

Women made up nearly four out of five people who got bariatric surgery in Canada, with the typical patient being a woman in her 40s with obesity and related conditions such as diabetes, high blood pressure or sleep disorders.

Freedhoff believes bariatric surgery should be part of the "constellation of care" used to deal with obesity. But he said it is not the most pressing issue related to obesity in this country.

"Really, what we need to look to is: Why are so many Canadians struggling with their weight?"

Canadian life is like a perfect storm for inciting weight gain, he suggested. Food advertising is ubiquitous, and foods are engineered to appeal to the taste buds rather than simply nourish.

"The 'bet you can't eat just one' phenomenon is a very real and engineered phenomenon," he said, referring to the tag line of a commercial for a popular snack food.

"It is not a personal choice. People aren't going to bed wanting and hoping and planning to continue to gain weight or not to lose. Quite the opposite. ... This is not something people desire or strive for. And if guilt and shame and desire were sufficient to lead people to sustainably lose weight, the world would be thin."

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