Access to Bariatric (Metabolic) Surgery in Canada

Severe obesity is reaching epidemic proportions throughout the world including Canada. The nonsurgical treatment of severe obesity is a life-long struggle, associated with high recidivism and suffering. Bariatric surgery is the only treatment modality that produces significant, sustained, long-term weight loss in patients with severe obesity. This is accompanied by substantial improvements in obesity associated diseases, particularly, Type 2 diabetes mellitus, hypertension, hyperlipidemia and sleep apnea which results in an overall reduction in mortality risk. In addition bariatric-metabolic surgery is very cost-effective. Despite these clear benefits bariatric-metabolic surgery is difficult to access in Canada with tremendous regional and provincial variation in bariatric-metabolic capacity in Canada resulting in extremely long waits for the surgery (up to 5 years). Provincial strategies such as those adopted by the Province of Ontario where the money follows the patient, i.e. the money given to the health care center is specifically marked for bariatric-metabolic surgery and the post-operative care services required, should be adopted by the remainder of Provinces and Territories across Canada.