As obesity surgery takes off, waiting lists grow in Canada

Canada's obesity epidemic is now at least a decade old and the country's health system is seeing many more cases of illness related to the condition: Type 2 diabetes, heart disease, high blood pressure, and arthritis.

To combat the problem, approximately 2,000 obesity surgeries, which include gastric bypass and laparoscopic banding, are being performed annually, according to Edmonton-based Dr. Arya Sharma, scientific director of the Obesity Network.

Demand for the surgeries continues to grow, leaving many Canadians on lengthy waiting lists or exploring other options.

Gastric bypass surgery, also known as stomach stapling, involves the surgical creation of a small pouch at the top of the stomach to reduce its size. The pouch, which can only hold about 30 grams of food, is then linked to the small intestine. The procedure is done laparoscopically, meaning there is no need to cut the entire abdomen open — only tiny incisions are  made.

In laparoscopic banding (lap band surgery), an alternative to gastric bypass, a surgeon inserts a doughnut-shaped device with an inflatable balloon around the upper part of the stomach. The idea is to create a small pouch, but unlike gastric bypass, the pouch is not connected to the intestine. The procedure is reversible.

Sharma says approximately 250,000 Canadians meet the criteria for the surgery. These include a Body Mass Index of 40, which means the patient is about 100 pounds overweight. To qualify, they also cannot have underlying health problems that may make surgery risky, emotional issues that will complicate recovery, have a history of drug or alcohol addiction or are on drugs that promote weight gain.

They are also advised that the procedures carry risks, such as one death in every 200 to 300 surgeries, blood clots, leaking at one of the staple lines in gastric bypass surgery and intolerance to certain foods.

For those who are good candidates for the procedure, the success rate is high, according to Sharma.

"The results of obesity surgery for the majority of patients are actually quite spectacular," he told CBC News.

Canadians seek surgery abroad

Though the total number of Canadians waiting for provincially-covered obesity surgery is unknown, demand has forced patients to travel outside their home provinces. Ontario alone has sent almost 400 patients to the U.S. for obesity surgery in the last 10 months.

Sharma says the long waiting lists are taking a toll. "Having to wait too long when you have a disease that is severely disabling and causing health problems is never a good situation.

"There's a lot of people out there who could really benefit from obesity surgery."

Nancy Kurtz, an Ontario resident, has seen a decided improvement in her health since having the surgery. Before she had obesity surgery last year, Kurtz weighed 123 kilograms (270 pounds).

Kurtz was told she'd have to wait three to five years to have the surgery in Canada, forcing her to explore other options. She took her savings and headed to India where doctors performed a gastric bypass.

She now relishes the sensation of being full. "It was a revelation to me. I thought: 'Well no wonder the rest of the world stopped eating, when you feel like this,'" she says. She has lost 109 pounds. 

Ontarian Jackie Mohammadi has waited two years for her surgery. She weighs just over 300 pounds, and rarely leaves her apartment. Opting for gastric bypass, surgeons will close off her stomach and leave her with a small pouch the size of a thumb. And she will need much less food.

"You eat and you feel full. And then you don't eat as much," says Dr. John Hagan, a bariatric surgeon at Humber River Hospital in Etobicoke, Ont.