By Rebecca Smith, Medical Editor- Daily Telegraph
Last Updated: 1:55am GMT 04/02/2008
More than one million prescriptions are being written for obesity drugs costing £47m a year while others are denied medication for cancer, it has been revealed.
The NHS bill for obesity drugs could pay for a new children’s hospital every two years.

Meanwhile women with advanced breast cancer are being denied Avastin because it has not yet been evaluated for use on the NHS.

The drug has already been turned down for use in advanced colorectal cancer because it is not cost effective.

Data from the NHS Information Centre shows in 2006, 1.06m prescriptions were written for orlistat, which blocks the absorption of fat from food, and sibutramine which acts as an appetite surpressant.

Prescriptions of the drugs have increased eight fold since 1999.

The money spent on the obesity drugs would pay for more than 2,000 women – two thirds of all eligible women – to have Avastin which can delay breast cancer spreading by an average of five months.

Critics said using drugs to treat obesity is not particularly effective as most patients put the weight back on after they finish their course of medication and so the money would be better spent on prevention measures or other conditions.

Dr David Haslam, clinical director of the National Obesity Forum, said obesity drugs have their place because they can reduce the chances of an overweight person developing health complications like diabetes but he added that the money would be better spent on stomach stapling surgery and other operations which are highly effective.

Last week the Government launched a major new obesity strategy focussing on prevention of the condition by encouraging a healthy diet and more physical exercise, especially in children.

Betty McBride, Head of Policy and Communications at the British Heart Foundation (BHF), said: “Obesity drugs are clearly part of the solution for a minority of people, however we are in danger of medicalising what is fundamentally a social problem.

“Behaviour change by living a healthier lifestyle is the key to treating and preventing obesity.

The Hospital Group are one of the first medical organizations to provide what are referred to as “balloon implantsâ€� – a new revolutionary weight loss treatment, ignored by the NHS, which could save thousands suffering from the effects of obesity and its associated diseases.

The Hospital Group, the UK’s leading provider of weight loss surgery, are set to insert silicone balloons into the stomachs of people who are over weight with a BMI of 30+ – making them eat less, feel full and re-learn eating habits over a period of six months.

The procedure is already popular in the States and experts are predicting it could provide the answer the Britain’s obesity crisis. Recent research shows that almost one in four adults are now regarded as obese and two thirds as being overweight.
As demand for weight loss solutions grow, The Hospital group predict that the gastric/silicone balloon could be the long awaited answer for short term weight loss. It is not, however, recommended for the morbidly obese – which Government watchdogs point as the reason why the NHS are turning a blind eye to such an effective weight loss treatment.

A new study from Brazil showed that patients who had this revolutionary treatment lost almost half their excess weight and with the gastric balloon suffered no side effects.

The gastric/silicone balloon is a non-invasive way of reducing the size of the stomach. A balloon is put in under sedation and the patient suffers only mild discomfort. Most patients say they don’t even feel that it is there. The objective of the balloon is to re-educate the patient about food and their relationship with it.

If patient starts to gain weight again they may require a gastric band or bypass. The gastric/silicone balloon is designed to act as a form of portion control allowing patients to lose weight whilst maintaining a healthy balanced diet.

Silicone balloon prices start at £3,950.
COSMETIC BLISS COMMENT – OUR BALLOON PRICES – FULLY INCLUSIVE OF FLIGHTS, ACCOMMODATION, REMOVAL AFTER 6 MONTHS AND ON-GOING SUPPORT AND AFTERCARE ARE ONLY £2,500 – WITH NO EXTRAS

Friday, February 08, 2008

By Victoria O’Hara – Belfast Telegraph
An Ulster woman last night said she was left devastated after being told – on the very day of the life-changing surgery she had waited months for – that it was only performed in England.

The woman, who is from the Antrim area, had her bags packed ready to undergo bariatric surgery – an elaborate procedure designed to promote weight loss – in the Royal Victoria Hospital, Belfast on Wednesday.

She had been preparing for almost four months after receiving a date for the operation in October.

Within 10 minutes of the hospital confirming there was a bed available she was left “stunned” when they rang back informing her a decision to cease bariatric surgery in Northern Ireland had been taken by health chiefs.

The woman, who wishes to remain anonymous, said she was left in tears as she had been “mentally prepping herself” for the surgery for months.

“The night before I couldn’t sleep, I felt like a child on Christmas Eve I was so excited,” she said. “This was supposed to be my new life.”

She added: “My friend was here ready to take me to hospital, I had the house cleaned and sorted out legal affairs.

“I had gone off work, told my children, packed my suitcase and set aside 12 weeks to recover. “There was so much to arrange.”

The surgery will take place in Leeds within four to six weeks.

She said she is now worried about how she will cope having the procedure away from home.

“Now I’m going to have to fly to Leeds on my own. And my eldest child is worried about me being on my own.

“I have been gearing up to have this done over the last five years. I am just so disappointed and angry.

She added: “The surgeon has contacted me and said he was sorry about the situation.

“I am not sure if it is a budget issue or what, but this shouldn’t happen to people. If a decision had been taken earlier, why wasn’t I told? Psychologically, it has a big affect on a person.”

Belfast Health and Social Care Trust issued an apology.

“The hospital was directed, under guidelines issued by the National Institute for Health and Clinical Excellence, to discontinue the procedure,” a spokesman said.

“Unfortunately, this information was not communicated in time to the patient and we apologise for the inconvenience,” he added.

11/02/2008 Daily Mirror 11/02/08
The NHS is facing a “perfect storm” of rising obesity, an ageing population and higher cost of drugs, a report warned last night.

Independent thinktank Reform said in its study that unless big changes are made the public will get worse treatment for more money.

It claimed: “Research points to a ‘perfect storm’ of rising demand.”

The think-tank argues that by 2031 obesity will be rife and there will be a third more adults of pension age. The Government is “in denial” and the remedy would be to allow in more private companies.

By DENISE GRADY New York Times
Published: January 23, 2008
Weight-loss surgery works much better than standard medical therapy as a treatment for Type 2 diabetes in obese people, the first study to compare the two approaches has found.

The study, of 60 patients, showed that 73 percent of those who had surgery had complete remissions of diabetes, meaning all signs of the disease went away. By contrast, the remission rate was only 13 percent in those given conventional treatment, which included intensive counseling on diet and exercise for weight loss, and, when needed, diabetes medicines like insulin, metformin and other drugs.

In the study, the surgery worked better because patients who had it lost much more weight than the medically treated group did — 20.7 percent versus 1.7 percent of their body weight, on average. Type 2 diabetes is usually brought on by obesity, and patients can often lessen the severity of the disease, or even get rid of it entirely, by losing about 10 percent of their body weight. Though many people can lose that much weight, few can keep it off without surgery. (Type 1 diabetes, a much less common form of the disease, involves the immune system and is not linked to obesity.)

But the new results probably do not apply to all patients with Type 2 diabetes, because the people in the study had fairly mild cases with a recent onset; all had received the diagnosis within the previous two years. In people who have more severe and longstanding diabetes, the disease may no longer be reversible, no matter how much weight is lost.

The operation used in the study, adjustable gastric banding, is performed through small slits and loops a band around the top of the stomach to cinch it into a small pouch so that people eat less and yet feel full. Other weight-loss operations are more extreme and involve cutting or stapling the stomach and rearranging the small intestine. Of the 205,000 weight-loss operations performed in the United States last year, 25 percent to 30 percent used the gastric banding.

Remission of Type 2 diabetes after weight-loss surgery is not a new finding; doctors have known about it for years. But the new research is the first effort to find out scientifically how it measures up against medical treatment in similar groups of patients with the disease.

The study reflects a growing interest among researchers in using surgery specifically to treat Type 2 diabetes, even in people who are not as obese as those who typically undergo operations to lose weight. The new thrust is in some sense a measure of desperation, as the United States and the world face increasing rates of the disease and its devastating complications, which can include heart attacks, blindness, kidney failure and amputation. To many doctors, the time is ripe for studying surgery as a potential cure for diabetes, and also as way to understand the disease better and develop better drugs to treat it.

Medical societies in the United States and abroad that once called their specialty bariatric surgery, a term that refers to weight loss, have started adding the word “metabolic� to their titles to emphasize the new focus on diabetes.

“I think diabetes surgery will become common within the next few years,� said Dr. John Dixon, the lead author of the study and an obesity researcher at Monash University in Melbourne, Australia, where the research was conducted.

The study and an editorial about it are being published Wednesday in The Journal of the American Medical Association.

The editorial, by doctors not involved in the study, said, “The insights already beginning to be gained by studying surgical interventions for diabetes may be the most profound since the discovery of insulin.�

A researcher who is not a surgeon and was not part of the research, Dr. Rudolph L. Leibel, co-director of the Naomi Berrie Diabetes Center at Columbia University Medical Center, said the study was important because it showed that a minimally invasive type of surgery could reverse diabetes.

“At this point,� Dr. Leibel said, “maybe we should be more accepting or responsive to the idea of surgical intervention for reducing or prevention of diabetes and its complications.�

But at the same time, he said, caution was in order, because the study lasted only two years and it would be essential to find out how these patients fared over time.

About 19 million people in the United States have Type 2 diabetes, and another 54 million are “prediabetic,� meaning they have abnormalities in their blood sugar that increase their risk for the disease, according to the American Diabetes Association. Diabetes is the fifth-leading cause of death by disease in this country, killing about 73,000 people a year. The number of cases in the United States is growing by about 8 percent a year, according to the association. Though treatable, the disease is not curable, and it is often poorly controlled.

The 60 people in the study had an average age of 47 and were assigned at random to have either surgery or medical care. All were obese, with a body mass index, or B.M.I., of 30 to 40. A B.M.I. over 25 is considered overweight, and over 30 is obese. (A person who is 5 feet 6 inches tall with a B.M.I. of 25 would weigh 155 pounds; with a B.M.I. of 30, 186 pounds; a B.M.I. of 35, 216 pounds; and a B.M.I. of 40, 247 pounds.)

Based on guidelines created by the National Institutes of Health in 1991, weight-loss surgery is generally only recommended for people whose B.M.I. is 40 or more, unless they also have Type 2 diabetes, in which case a B.M.I. of 35 is the cutoff. In this study, 13 people, or 22 percent, had a B.M.I. under 35.

Medicare covers weight-loss surgery according to the institutes’ rules, but many private insurers refuse to cover the surgery at all, said Dr. Philip Schauer, director of the bariatric and metabolic institute at the Cleveland Clinic. He said his center had to turn away three or four patients for every one accepted because insurers would not pay.

On average in the United States, banding costs $17,000 and the other bariatric operations $25,000.

Dr. Schauer said that the B.M.I. cutoffs did not make sense medically and that the study “blows away this arbitrary barrier.� He said that the cutoffs should be lowered, so that a patient with diabetes and a B.M.I. of 34.9 would not be considered ineligible, as is now the case.

Dr. Francesco Rubino, director of the metabolic surgery program at NewYork-Presbyterian/Weill Cornell Medical Center, also said that the criteria for the surgery should be changed so that it could be offered to diabetes patients early enough to reverse the disease.

Dr. Rubino and other researchers said that weight-loss operations that rearranged the small intestine had faster and more powerful effects on diabetes than did the banding, because the other operations changed the levels of certain gut hormones that greatly improve the body’s ability to control blood sugar, weight and lipid levels in the bloodstream. These operations, and the hormones responsible, have become the focus of intense research.

Dr. Dixon has received research grants and speakers’ fees from the company that makes the gastric bands, Allergan Health, and the company paid for the study through a grant to the university. But his report said the company had no influence on the design of the study, the data or their report.

The editorial writers said they had accepted travel grants from Allergan and other companies to attend a conference on diabetes surgery in Rome.

13 Feb 2008 – www.lookinggood-feelinggreat.co.uk
The perception of undergoing liposuction as an instant measure to lose weight is a “common misconception”, according to independent consumer advice portal Looking Good BuyAssociation.

Liposuction is intended for people who have unevenly distributed fat deposits on parts of the body including the stomach, thighs, buttocks and arms that diet and exercise alone cannot remove.

Felicity Quigley, editor of Looking Good BuyAssociation, said: “The thing about liposuction is that, number one, it doesn’t actually reduce cellulite… the best candidates for liposuction are people who have actually tried diet and exercise, have tried to shift pockets of fat that they can’t get rid of, and it’s about getting rid of it that way; it’s not about losing weight.”

The latest figures from the British Association of Aesthetic Plastic Surgeons (BAAPS) show that 32,453 surgical procedures were carried out by BAAPS members in 2007 – up 12.2 per cent from 2006.

Ms Quigley revealed that a new alternative non-invasive liposuction procedure is set to launch in the UK using lasers.

However, while technological advances in cosmetic surgery are facilitating a rise in non-invasive procedures, she warned that people considering surgery must do their research first and understand the potential risks involved.

The Scotsman 04/02/08

RECORD numbers of people across the UK are going under the knife, according to new figures which show a large increase in plastic-surgery procedures.

The figures, released by the British Association of Aesthetic Plastic Surgeons (Baaps), show the stigma of “having some work done” is falling away.

Some 32,453 people chose to have cosmetic surgery last year, an increase of 12 per cent on 2006, when 28,921 procedures were carried out.

Facelifts are becoming ever more popular according to data, with 4,238 women opting for the procedure last year, a rise of 37 per cent on 2006.

Breast implants remained the most popular procedure, with 6,497 woman undergoing the operation, while 5,148 women had eye surgery, and 3,990 women had liposuction, an increase of 15 per cent.

While 91 per cent of all cosmetic surgery was carried out on women, the figures show more men than ever are open to “self-improvement”.

Last year, 98 men had tummy tucks, a rise of 61 per cent, while the number of males who had liposuction rose by 18 per cent.

Leading plastic surgeons believe factors encouraging the trend include the higher profile of surgery – driven by a rise in TV shows featuring live cosmetic work – and the availability of “softer” options such as botox, which act as an introduction to the idea of face “rejuvenation”.

Douglas McGeorge, consultant plastic surgeon and president of Baaps, said: “This year’s audit clearly reflects the UK’s continued acceptance of aesthetic surgery, particularly in the area of anti-ageing.

“Wide media coverage has helped educate the public about the latest advances and choices available, but it is crucial that people do their research carefully when choosing a provider.”

Rajiv Grover, consultant plastic surgeon and Baaps secretary, said that the dramatic rise in surgery may be related to the increase in non-surgical cosmetic treatments such as face “fillers” and peels.

He added: “The effects of these less invasive treatments can sometimes be limited once jowling or loose skin has developed, so this could explain why more patients now feel ready for the surgical option.”

Concerns have recently been raised about the growth of the industry – predicted to be worth £1 billion by the end of 2008.

Last month, consumer body Which? revealed many clinics used hard-sell techniques to encourage people to opt for expensive or risky operations.

Undercover researchers found unqualified sales assistants made false claims that procedures would last for life, or offered two-for-one deals.

Psychologists also claimed the statistics highlighted a worrying social trend.

Dr Cynthia McVey, head of psychology at Caledonian University, said: “We judge people on youth and beauty, rather than character and behaviour.

“We are all going to get older, but a sense of attractiveness should be more than skin deep.”

She added that the increasing willingness of celebrities to admit to “having work done”, as well as the reduction in cost, had helped legitimise surgery.

Cary Cooper, professor of psychology at Lancaster University, said: “Some people have a psychological need to have their nose or their tummy or their breasts done to make themselves feel better. They are quite genuinely in psychological distress.

“But I think what we are seeing is a definite rise in the number of people that see surgery as a way of helping them get on – to get a better job or be more successful with the opposite sex.