Bariatric surgery – why aren't we doing more of this?

In the Western world obesity is an enormous problem, which we are tending to ignore - quite literally
the elephant in the room. Thousands of books and magazines discuss different diets to lose weight, almost all of them provide short-term but no long-term benefit. The fact that there are so many diets confirms that none are successful.
There is no debate that the major cause of this as we are eating far too much sugar, and medical advice in the past to not eat fat makes the profession equally as guilty as their patients. We are talking about taxing sugar, soft drinks, making them R16 etc. and while this may well make a difference in the long term, there are tens if not hundreds of thousands of people who are moderate to morbidly obese who have been left in limbo. If diets don't work, how can they possibly lose weight?
The medical profession and many others look at them and say "it's their fault"  they eat too much and don't do enough exercise. But losing weight and keeping it off is extraordinarily difficult. At the same time people with severe obesity developed diabetes, hypertension both of which lead to heart attacks, heart failure, strokes and possibly cancer. The cost of both the medicines to treat these diseases long-term is significant, and is a great deal more expensive than one single operation!

2 recent studies in the Journal of the American medical Association show just how effective bariatric surgery is.
In one study 932 people had an operation and the 956 were treated medically with intensive dieting advice, followed for 6.5 years.   High blood pressure was "cured" in 32% of the surgical compared to 12% the medical group. Only 2% of the surgical group developed high blood pressure over 5 years while 12% of the medical group did.
Diabetes was "cured" in 57.5% compared to 14.8% of those treated optimally medically, and only 0.3% developed diabetes compared to 7.5%.
In the second study looking at diabetes, of the 40 patients having gastric bypass, at 5 years 55% had their diabetes controlled against 14% of the intensive medical group.   They did however, not surprisingly, have more gastric surgical complications (66 vs 38 events).   So the surgery should only be done by skilled gastric surgeons.

50% reduction in diabetes and 32% reduction of high blood pressure - These benefits are huge, and will represent an enormous difference in medical costs over the years, save many lives, and reduce the misery of these patients.
Surprisingly compared to other studies there is an increased incidence of depression (8.9 compared to 6.5 in the medical group) on those who had the operation.

I believe bariatric surgery should be available to many more people, it will save lives, improve quality of life and saved medical expenses far outweighing the cost of the operation. Obviously people who have the operation should be followed up carefully, and any psychological problems discussed. I have a suspicion that many people after the operation are discharged as "cured".
It's also extremely likely that the bypass will affect the absorption of some nutrients, particularly vitamins and minerals, and these patients should be given good multivitamins and multi minerals, fish oils and probably calcium and magnesium on a regular basis. They also need to have their vitamin B12 checked, as the intrinsic factor created in the stomach is essential to absorb B12, and they may require B12 injections.

Hopefully in the future when we can cut down on the sugar this will no longer be a problem, but I think we do need to be holding out a helping hand to the current generation of obese people that the medical profession and food manufacturers have created.