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.
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.
Cost to B.C. medical system of dealing with complications from medical tourism: $30,000 average per case.
Current Wait Times 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 2010/2011, 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.