While Finns are getting fatter, there are still too few surgeries carried out each year to combat the growing obesity epidemic, according to experts
Every year, around one thousand people have surgery for obesity problems in Finland, but doctors say the need is five times greater than that. In Sweden for example, more than 6000 obesity surgeries are carried out each year.
Some reasons for the low number of surgeries in Finland include a lack of sufficient resources in basic health care to support patients in pre-surgery weight loss, as well as attitudes of doctors and patients about how to treat weight problems.
“There is the attitude that if a person has ‘eaten themselves fat’, then why should they get surgery paid from public funds?” says Olli Nyberg, President of Lilen, Finland’s Obesity Patient Association.
Lilen has applied for a grant to train health care professionals about obesity surgery and post-treatment follow-up care, which Nyberg says is lacking.
“Due to lack of monitoring and support, some of the surgery patients will have mental health problems. Drug abuse problems are more common when one addiction changes to another. There are some problems too when a spouse is unable to handle the situation mentally” he says.
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According to experts, tens of thousands of patients in Finland with obesity-related health problems would benefit from surgery. Advocacy groups appealed to the government and healthcare policy makers last year for an increase in the number of surgeries carried out at public expense, but so far there’s been no change in surgery figures.
Treatment of obesity and related diseases works well within the basic Finnish health care system, says gastrointestinal surgery specialist Anne Juuti. She says obesity is mainly treated with conservative treatment, such as individual or group or weight loss advice. Often, obese patients can only qualify for surgery after a period of initial weight loss.
According to current care recommendation, the first step in surgery is conservative treatment. If that option is not available in all primary health care units, not all of those who have surgery will benefit from the treatment, Juuti explains.
Kirsi Markula, a health center doctor from Salla, feels that the requirements for obesity surgery are too strict. Markula says she has sent letters requesting surgery even for patients who don’t quite meet the full criteria.
“I have tried to explain why the patient should be operated on” says Markula. “Should the requirements be relaxed and the patient evaluated individually if he wants the surgery but his weight remains a couple of kilos above the requirement criteria?” she asks.
Obesity surgery in Finland is only authorized for health reasons. The most common surgical procedure is gastric bypass surgery.
Health risk factors which could lead to obesity surgery include Type 2 diabetes, asthma, hypertension, coronary heart disease and sleep apnea.
In Finland, obesity surgery costs about €9000 in a private hospital; and about €7600 in the public sector.
More Finns are opting to travel to Estonia or Latvia for their surgeries, where the costs are considerably cheaper.