Waiting for Weight Loss

wait for surgeryA Canadian woman, upset about being put on a 10 year waiting list to receive bariatric surgery, decided to write her own obituary and send it to Canadian health agencies.  The story of 42-year-old Lillian Coakley from Nova Scotia was published in an article this month. Coakley is on a waiting list with more than 2000 other obese people in her province. She sent an email to health and government officials, pointing out the failures of the country’s policies on obesity treatment and included her own obituary. She told officials that her body was to be cremated, to save her family the ridicule of having to find dozens of pallbearers or have her body carried by a tractor.  Her email went viral and eventually led to an offer for free treatment, but in Mexico.  Coakley is nervous about the idea of leaving her country to receive surgery, but even more nervous about the idea of waiting years to receive a treatment that she needs now.

Coakley suffers from several health conditions, including sleep apnea, high blood pressure and asthma. Her health could very well deteriorate in the ten years she could spend waiting to receive surgery and her modest salary does not allow for her to seek treatment in a private clinic, where the surgery would cost her about $10,000. The fact that Coakley is on a waiting list of 10 years for a surgery that will extend her life, potentially cure her health conditions and improve her quality of life really doesn’t speak well to the state of health-care funding for Canadian obesity treatment programs.

Dr. Patrick Chiasson, expert bariatric surgeon in Tucson, Arizona, spoke with us about the article. He said “Canadians are starting to realize the enormous public health issue that the Obesity Epidemic poses to their society.  This article does much to highlight the slow response of the Canadian Health Care system to address this issue.  At present there are very limited resources that have been earmarked for fighting Obesity in Canada.  For many years patients have been traveling to the USA and abroad for weight loss surgery.  Now that these services are starting to be performed locally, it is readily apparent that the system has not been geared up to address the overwhelming need that exists to care for morbidly obese individuals.”

Dr. Chiasson explained that the fact that there are 2000 patients on the wait list in the Maritimes for weight loss surgery is a reflection of the fact that there are few dedicated Bariatric surgeons working in the region and limited capacity in the system.  He concluded that “This issue will not have resolution until there is political leadership and will to address issues of obesity at every level of society; including the need to have a high capacity bariatric surgery program for the region.”

In response to this issue of long waiting lists for obesity treatment in Canada, some Canadian researchers designed a ranking system to help determine who should be treated first. The system is called the Edmonton Obesity Staging System and it ranks obese people from zero (which indicates no apparent medical risk, although his or her weight is considered obese), to stage four (which is the most severe, with end-stage chronic diseases, severe disabilities and functional limitations).  As the stages progress from 0 to 4, the medical problems become more serious.

The study showed that you cannot look at BMI alone to determine who risk is at the most for premature death because obesity doesn’t affect all people the same way.  One obese person could lead a healthy life while another person with the same body mass index could have severe medical problems. Genetics and family history have a large impact on who will suffer from health problems and be at risk for an early death.  Diet and fitness level also play a part in the health of obese people.
The researchers did find an association between health complications and heavier weight – but they also found exceptions, where some people were relatively healthy despite being obese.

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