NICE lowers BMI threshold for weight-loss surgery in diabetes

More people with type 2 diabetes will be offered weight-loss surgery on the NHS under NICE proposals to tackle rising cases of the disease.

Obesity: NICE says more people with diabetes should have surgery (Photo: Jason Heath Lancy)
Obesity: NICE says more people with diabetes should have surgery (Photo: Jason Heath Lancy)

The plans restate existing advice to offer bariatric surgery to patients with type 2 diabetes and a BMI over 35, while advising clinicians to consider an assessment for surgery in diabetes patients with a BMI as low as 30.

It follows fresh evidence showing more than half of people undergoing surgery achieve better control of their diabetes.

Cases of diabetes and obesity have soared in recent years. Estimates suggest 700 people are diagnosed with type 2 diabetes each day, and the proportion of people who are obese has risen from around one in eight to a quarter of the population in the last 20 years.

Updated draft NICE guidance on obesity, published on Friday for consultation, advised that anyone diagnosed with type 2 diabetes in the past 10 years and with a BMI of 35 or over should be offered an assessment for surgery.

Such an assessment can also be considered in those with a BMI of 30 to 34.9. People of Asian family origin should be considered for surgery at an even lower BMI.

Very-low-calorie diets discouraged

NICE has also discouraged routine use of very-low-calorie diets for treating obesity, following evidence over their benefit and safety. These diets see people consume fewer than 800kcal per day.

Current guidance that recommends bariatric surgery as a treatment option for all people with a BMI over 40 remains unchanged.

Professor Mark Baker, director of NICE's Centre for Clinical Practice, said: 'Obesity rates have nearly doubled over the last 10 years and continue to rise, making obesity and overweight a major issue for the health service in the UK.

'Updated evidence suggests people who are obese and have been recently diagnosed with type 2 diabetes may benefit from weight-loss surgery. More than half of people who undergo surgery have more control over their diabetes following surgery and are less likely to have diabetes-related illness; in some cases surgery can even reverse the diagnosis.'

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