Tell us your views on commissioning guidelines for body contouring surgery

BOMSS promotes the safe and effective use of surgical strategies as part of a co-ordinated pathway of care for the severely obese individual. As such it recognises that Body Contouring surgery (BCS) is a crucial component of a continuum of care for post-bariatric surgery patients. It therefore strongly supports the process of development of clear, practical and clinically sensible guidance for commissioning Body Contouring practice.

Many successful bariatric surgery patients inevitably suffer from physical and psychological problems secondary to loose skin and we strongly concur with the evidence provided in the document that there are significant quality of life benefits following BCS.

Following weight-loss surgery (and all other forms of weight loss) there are predictable changes in weight and associated body mass index (BMI). BOMSS has a significant concern that the BMI cut-off of 27kg/m2 is set at a level that many successful patients may never reasonably attain. These patients often have significant functional impairment from copious excess skin, despite having a high residual BMI. It recognises that there is still uncertainty over risks and benefits of BCS at increasing BMIs but believes that the threshold in this document is set too low and believes this should be reviewed.

BOMSS recognises too that there are resource implications of any commissioning guidance. The distribution of resource may also be biased by this stringent guidance as many patients require more than one procedure. This mechanism of allocation may mean that some deserving patients may have no access to BCS, whilst others have access to multiple procedures. Another stance may be to increase the BMI of eligibility but place guidance on frequency of interventions.

Nevertheless, BOMSS recognises that it is likely that the guidance will need to stipulate a prioritisation group. It would strongly recommend that, in view of the evolving evidence on this clinical area, there is a commitment in the document for a timetabled review process and recommendation that resources should be developed to accommodate a likely increasing need in the near future.

As part of the ongoing process, we would like to hear views from our members. Please email

Excellent scientific line-up for Leamington Spa

The BOMSS 2014 Scientific Programme can be viewed on the BOMSS Microsite and includes a very impressive line-up of international speakers including Dr Bruno Dillemans from Bruges, Dr George Fielding from New York and Dr Michel Gagner from Canada.

The Early Bird Registration rate for the BOMSS 5th Annual Scientific Meeting will close on the 1st December 2013, so register now by clicking here. Your accommodation can also be booked online by clicking here.

ByBand study update

The latest newsletter of the By-Band study – comparing the effectiveness, cost-effectiveness and acceptability of Band versus Bypass surgery for the treatment of complex obesity – has been issued and can be viewed here.

BOMSS president Mr Richard Welbourn and council member Ms Sally Norton are members of the By-Band steering committee.

Looking forward to Leamington Spa

Members of the Scientific Meeting organising committee visited Chesford Grange near Leamington Spa to plan the programme for BOMSS 2014.  Ms Sally Norton, Mr Vinod Menon and Professor Duff Bruce from the BOMSS Council met with Ms Sarvjit Madhar and Ms Nichola Coates of the AUGIS secretariat to inspect facilities at the hotel.

bomss2014venueThe first impressions were good – it’s an easily accessible and lovely venue with ample parking with the nearby Ramada Hotel for overspill. Transfers from Birmingham Airport and local train stations are quick and easy.

At the hotel, a traditional reception provides access to 205 guest rooms which we expect to fill with BOMSS members. Moving through the hotel there is a spacious open plan-bar with an outside deck area – which may or may not be welcoming in January!

A modern conference centre is attached to the hotel and offers fantastic facilities for all of the usual BOMSS activities. A newly built annex toward the rear of the hotel will be an ideal hub for the BOMSS teaching day and poster exhibition. Mr Sean Woodcock and Mr Alan Osbourne are planning a full and varied programme for the multiple-disciplinary delegates on the Training Day.

The scientific programme for the main meeting is developing nicely with international guests lining up to take a variety of roles at the event.

For visitors, the nearby region is, of course, the heart of Shakespeare Country, close to the attractions of Warwick Castle and surrounding towns.

Adverts for the meeting will soon appear on the BOMSS website – members are urged to look out for them and book their place.

Obesity and Disability resource

The Public Health England Obesity Knowledge and Intelligence team (formerly NOO) has produced the following new resource:

Obesity and disability – adults

This paper examines evidence linking obesity and disability among adults.  It looks in detail at the most prevalent disabling conditions in the UK, explores inequalities in relation to obesity and disability and highlights implications for health and social care.

All publications may be accessed via the PHE Obesity Knowledge and Intelligence website:

NICE to focus on obesity

The quality standards programme for the National Institute for Health and Care Excellence (NICE) will be substantially broadened to cover topics affecting public health, including obesity.

NICE will work with experts from Public Health England to initially develop three new public health quality standards.
The standards will cover strategies to prevent obesity in adults and children, reducing tobacco use in the community and preventing harmful alcohol use.

The majority of people in England are currently either overweight or obese, which increases the risk of type 2 diabetes, heart disease and certain cancers and costs the NHS more than £5 billion per year.

The new quality standards will be based on existing public health guidance produced by NICE and will consist of a set of statements designed to drive and measure improvements in healthcare.

They follow the introduction of new public health responsibilities for local authorities which came into effect in April 2013.

Professor Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE said: “We are very pleased to have been asked to produce public health quality standards.

“They will be a valuable tool for local authorities as they take on their new public health functions, and for Public Health England. By bridging the interface across health, social care and public health, NICE public health quality standards will help support integration across the three sectors.

“They will also ensure that those responsible for commissioning services will have access to the complete picture of what “

New Council member announced

Consultant surgeon Mr Marco Adamo has been elected to the BOMSS Council and will take up office from September. BOMSS Treasurer Mr Roger Ackroyd said: “I am sure everyone will join me in congratulating Mr Marco Adamo on his successful appointment to Council and I look forward to working with him in the future.”

BOMSS unveils new professionals standards

BOMSS has produced new standards aimed at helping surgeons achieve the highest possible level of conduct in bariatric practice.

The BOMSS Code of Ethics and the BOMSS Professional Standards Document set standards for bariatric specialists in this challenging area of surgery and health care.

The guidelines can be seen at: ( and
Both sets of guidance will be reviewed in 2015.

Mr Richard Welbourn, the President of BOMSS, said: “I am delighted to announce the publication of the BOMSS Code of Ethics and the BOMSS Professional Standards Document.

“Bariatric surgery is challenging due to the large size of patients, restricted laparoscopic access and the unique physiology of the severely obese. Weight loss and metabolic surgery requires advanced skills and specific training and is already carried out to an extremely high standard in the UK. We are working to ensure the highest standards of care are carried forward.”

Bariatric and Metabolic Surgery Fellowships 2013

Ethicon, part of Johnson and Johnson Medical Limited, are pleased to confirm that it will be supporting six, twelve month Bariatric and Metabolic fellowships from October 2013. These fellowships, supported by an unconditional grant from Johnson and Johnson, are highly popular.

Applications are invited for Fellowships in Bariatric and Metabolic Surgery at North Tyneside, Sunderland, UCH London, Luton, Imperial and Taunton. (Fellowships RCS Eng Approved). Fellowships will run for a period of twelve months and will commence October 2013. Click on the document below to find out more information:

Bariatric and Metabolic Surgery Fellowships 2013