Patients With Severe Obesity Undergo Bariatric Surgery Too Late

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Dr Ruth Mackenzie, Professor Jen Logue and the SurgiCal Obesity Treatment Study (SCOTS) team have published in BMJ Open this week 

The paper, ‘Surgical Obesity Treatment Study (SCOTS): a prospective, observational cohort study on health and socio-economic burden in treatment-seeking individuals with severe obesity in Scotland, U.K.’, describes how patients in Scotland being assessed for weight loss (bariatric) surgery are older and have a higher weight than the international average.

The SCOTS team report that a higher body mass index (BMI), combined with older age, is associated with poor physical functioning and required use of specialist aids and equipment in the home.

In addition, the team reveal that within the SCOTS cohort, patients who are oldest and have the highest BMI, have quality of life scores equivalent to those reported by cancer patients receiving palliative care, or by patients with end stage renal failure.

Professor Logue (formerly of SCMH and now of Lancaster University) said, “Our findings demonstrate that we need to act much earlier to ensure that people with severe obesity are not significantly disabled by the time they are receiving treatment.

“We also need more research to understand the health effects, as well as the best treatment of very severe obesity. Most commonly, patients with a BMI of over 40 – or sometimes over 30 – are classed in a group together within research studies; but our study shows that health status is substantially lower as BMI increases, and as age increases.

“Policy makers must consider the health and care needs of these individuals and invest to provide increased access to effective weight management.”

SCOTS is funded by the National Institute for Health Research (NIHR) [Health Technology Assessment (10/42/02)].

Read paper here -


First published: 30 August 2021