Dear ____

I’m writing to share with you a very personal experience that has significant ramifications for public policy. 

I’ve struggled with my weight for ____ years. Over this time, I tried many extreme diets and, while I would lose as many as ___ pounds, I always gained it back.  

This cycle of weight loss and gain wore on me and over time my weight continued to increase. Then came the co-morbidities of obesity. I developed ______. I was put on multiple medications and the number of visits to my family doctor and specialists went up. Net result – more costs to the healthcare system. I was losing this struggle – and costing the health system an extraordinary amount of money.

After ___ months on a wait list, I was enrolled into the Richmond Metabolic and Bariatric Surgery program. This is one of two centres of excellence in the province. The program started by teaching me that obesity is a disease caused by complex interplay between hormones in my gut and centres in my brain. This is part genetics and part due to the way my body metabolizes nutrients differently than non-obese people. They also taught me that I am not alone as there are more than 700,000 British Columbians who suffer from this disease.

After months of counselling to improve my diet and help me to develop positive coping mechanisms, I was ready for surgery. I had now waited a total of ___ months for (___ months waiting to enter surgery and ___ months preparing for surgery). Fortunately, this was covered by MSP, but the number of procedures is limited to 400 surgeries per year across the province (for reasons that are perplexing). I was one of the lucky ones!

I’m now ___ years post-surgery and am doing great! My weight is down ___ and my quality of life is dramatically improved. My ongoing success now depends on me following a close diet and exercise regime and ongoing support from the multidisciplinary care team, but none of this was possible without surgery. That was the tool I needed to succeed.  

And today, I am off of ___ medications. My ___ are improved/in remission. I am costing the health care system a LOT LESS MONEY.

The current wait just to get into the program is 28 months! This is not fair for patients and is costing the system millions (an estimated $1.4 billion is spent on the complications of obesity compared to the $5.2 million spent on curative surgery).

I thank you for reading my story and hope that you can help to encourage the Ministry of Health to improve access to this care for the thousands of British Columbians who suffer from obesity and are sitting on impossibly long wait lists due to limited funding. As my MLA, I hope your voice can help make crucial changes in this province!

I’ve attached a fact sheet from your information. 

Kind regards,






BACKGROUNDER:

BARIATRIC SURGERY: ITS HEALTH AND ECONOMIC BENEFITS


British Columbia will spend an estimated $1.9 billion on diabetes in 2020. A government report from 2016 estimated the economic burden of obesity to be roughly $1.48 billion. By contrast, $5.2 million is spent on bariatric surgery, by far the most effective curative treatment for obesity and diabetes. 
 Bariatric surgery results in remission of up to 82% of type 2 diabetes cases, 74% of sleep apnea cases, 70% of hypertension cases, 72% of gastroesophageal reflux disease, 41% of osteoarthritis and 25% of heart disease.  The New England Journal of Medicine reported a 40% decrease in mortality over seven years following bariatric surgery — including a 92% decrease in mortality from diabetes, a 60% decrease in mortality from cancer and a 56% decrease in mortality from coronary artery disease. 
Cost of bariatric surgery, plus five years of surveillance, to eliminate metabolic syndrome: $13,000
 Costs of common complications of metabolic syndrome:  Renal failure Dialysis: $60,000 per year Kidney transplant: $23,000 plus $6000 per year 
Heart disease Coronary artery bypass graft: $18,000  Peripheral vascular disease Endovascular aneurysm repair (or endovascular aortic repair): $13,000 – $26,000. 
Diabetes
A comparison of diabetic patients before and after gastric bypass followed over three years indicated an average cost saving of $2,000 per year for medications — not including visits to doctors, hospital admissions and testing kits. 
Medical tourism
Cost to B.C. medical system of dealing with complications from medical tourism: $30,000 average per case.
  Current waitlist for bariatric surgery in B.C.  GP referral to orientation: 28 months (up 17% in past 10 months) Preconditioning: 6 to 9 months Wait to time to surgery: 1 to 2 months

Total wait time: 35 – 39 months 

Comparisons by province
 British Columbia funds 400 bariatric procedures per year. 

In 2010/’11, the Provincial Health Services Authority (PHSA) developed a business case that recommended 1,000 to 2,000 procedures per year.  By contrast, Alberta performs 625 procedures per year (twice as many as British Columbia per capita); Ontario performs 3,500 (triple British Columbia's rate per capita); and Québec performs 3,800 (five times per capita the number British Columbia performs). 
Obesity disproportionately affects women, persons with disabilities, those in low socioeconomic strata, indigenous people and people with histories of abuse, mental health disorders and substance abuse.