BOMSS supports call for better obesity services in Wales

BOMSS – along with the The Royal College of Surgeons – has responded to the National Assembly’s Health and Social Care Committee report into the ‘Availability of Bariatric Services’ in Wales.We welcome the report’s call for the government to fully implement the All Wales Obesity Pathway. This will serve to optimise patients’ outcomes and ensure that patients in Wales have access to sustainable, safe and high quality bariatric services.

In a report, published today, the Health and Social Care Committee say just one out of seven health boards has sufficient Level Three specialist services – which include weight management clinics – in place for obese patients.

During its inquiry, the Committee found that the Welsh Government’s All Wales Obesity Pathway focuses on tackling the issue but needs to be fully implemented for all patients to receive consistent services which can help them with lifestyle, exercise and dietary regimes.

Currently 59% of adults in Wales are overweight or obese.

FRCS honour for Dr Henry Buchwald

Bariatric surgeon Dr Henry Buchwald has been award an honorary FRCS (Fellowship of the Royal College of Surgeons) in recognition of his surgical work.

Dr Buchwald, who practices in the US, has been a leader in bariatric surgery for 40 years and has served as President of the American Society of Bariatric Surgery and International Federation of Surgery for Obesity.

BOMSS President Mr Richard Welbourn said: “This is a well-deserved honour for Dr Buchwald. He has made a tremendous contribution to bariatric surgery over several decades.”

Professor Alberic Fiennes, past president of BOMSS, and BOMSS council member Mr Kesava Mannur are pictured with Dr Buchwald (centre) at a dinner to mark his achievements.


BOMSS welcomes new body contouring commissioning guide

A body contouring commissioning guide, which aims to address variation across England in provision and quality of body contouring surgery for patients who have undergone massive weight loss, is launched by the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) and the Royal College of Surgeons (RCS).

BOMSS contributed to the consultation about the guidance and welcomes its publication.

Full details can be found here

Concern over obesity rates in Wales as medical professionals call for better funding for bariatric surgery

Surgeons and healthcare professionals in Wales are concerned over a lack of funding for bariatric surgery and obesity treatments across the country, despite the launch of an all-Wales strategy more than three years ago.

The Royal College of Surgeons Professional Affairs Board in Wales and the British Obesity and Metabolic Surgery Society (BOMSS) have outlined their concerns in a written submission to the National Assembly for Wales’ Health and Social Care Committee Inquiry into the availability of Bariatric Services in Wales.

The document highlights that both organisations believe the current system in Wales is skewed and results in patients being forced to wait until they develop life-threatening illnesses such as diabetes or a stroke before they meet the qualifying criteria for surgery.

Consultant surgeon and BOMSS member Jon Barry, based at the Morriston Hospital Swansea, says: “We have serious concerns about a lack of access to weight management and preventative services in Wales. We believe that patients are being denied life-saving and cost-effective treatments and effectively encouraged to gain more weight in order to have a more complex operation further down the line. We believe to limit surgery to the most severely obese is denying patients effective clinical treatment and a better quality of life.”

The Royal College of Surgeons and BOMSS are calling on the Welsh Government to fully implement the recommendations in Welsh Health Specialised Services Committee’s ‘Review of Bariatric Surgery Provision and Access Criteria in the Context of the All Wales Obesity Pathway Report’ to optimise patients outcomes and ensure that patients in Wales have access to sustainable, safe and high quality bariatric services.

They also want a “step by step increase” in the population rate of bariatric surgery to ensure a move to full compliance with NICE guidelines and BOMSS standards.

National Institute for Health and Care Excellence (NICE) guidelines stipulate morbidly obese patients with a BMI of 40 or higher should have access to bariatric surgery, or with a BMI of 35 or higher if they suffer from other obesity-related illnesses.

However, in Wales, current restrictions mean patients require a BMI higher than 50 – and to suffer from other related health problems such as high blood pressure, diabetes or cardiovascular disease – before they can access surgery.

There is currently only one unit in Wales funded to provide obesity surgery, the Welsh Institute of Metabolic and Obesity Surgery (WIMOS) at Morriston Hospital, Swansea. WIMOS provides a full multi-disciplinary team, pre-operative assessment and follow-up service for two years following surgery. WIMOS has two full time consultant bariatric surgeons. Currently, patients in North Wales travel to England to have surgery.

Notes to editors

• The Royal College of Surgeons is a professional body that sets the highest possible standards for surgical practice and training in order to deliver safe and high quality patient care. The Royal College of Surgeons Professional Affairs Board in Wales provides a means by which surgeons at the front line can work together to share information, bring concerns to local decision-makers and look for solutions which benefit patients and lead to better patient outcomes.

• The British Obesity & Metabolic Surgery Society (BOMSS) is the professional society of surgeons involved in obesity management. Membership of the society includes medical professionals and allied health professionals including specialist nurses, psychologists and dieticians. BOMSS aims to promote the development of high quality centres for obesity surgery, to educate and train future obesity surgeons and practitioners and to guide commissioning and policy for the use of obesity surgery in the UK.

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: