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Inequalities in bariatric surgery in Australia: findings from 49 364 obese participants in a prospective cohort study

To the Editor: On behalf of the Medical Technology Association of Australia, we would like to commend the findings of Korda and colleagues on the inequalities in patient access to bariatric surgery in Australia.1

One issue that can be identified in the study is the inclusion of individuals with body mass index (BMI) in the range of 30–34 kg/m2. It is clinically accepted worldwide that individuals with BMI ≥ 30 kg/m2 are classified as obese. However, according to Australian clinical guidelines and other clinical guidelines, bariatric surgery is recommended for individuals with morbid obesity (BMI ≥ 40 kg/m2) or with BMI 35–40 kg/m2 and comorbid conditions.2,3 Therefore, including only those individuals considered to “need” bariatric surgery would allow for more accurate findings in showing inequalities in patient access to bariatric surgery.

We agree with the finding that bariatric surgery is mostly taken up by those who have private health insurance and who can afford the out-of-pocket costs…