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The efficacy of bariatric surgery performed in the public sector for obese patients with comorbid conditions

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Obesity (body mass index [BMI] ≥ 30 kg/m2) is a growing health problem and is recognised as one of the largest contributors to the chronic burden of disease. Currently, 28% of Australians are obese, placing our nation second for men and fifth for women among OECD (Organisation for Economic Co-operation and Development) countries ranked by prevalence of obesity.1,2 In Australia, an inverse relationship exists between high obesity prevalence and low socioeconomic status; incidence is almost double for areas indexed as the most disadvantaged compared with areas within the highest strata.3 Those living more remotely also have higher obesity rates — 59% versus 32%.2 Among Indigenous Australians, the prevalence of obesity is almost double (34% versus 18%) and that of type 2 diabetes mellitus (T2DM) is triple that of non-Indigenous adults, resulting in sevenfold greater mortality due to diabetes.2,4

Bariatric surgery is an effective treatment of severe obesity (class III [BMI ≥ 40 kg/m2] or class II [BMI ≥ 35 kg/m2] with comorbid conditions) and is purportedly cost-effective, compared…