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Body contouring

UK commissioning guidelines for body contouring

New guidance will need to stipulate a prioritisation group

British Obesity & Metabolic Surgery Society (BOMSS) has announced its support for the current process of developing clear, practical and clinically sensible guidance for commissioning Body Contouring practice and has also called for further input from bariatric professionals.

“We promote the safe and effective use of surgical strategies as part of a co-ordinated pathway of care for severely obese people,” said BOMSS Council member, Professor Duff Bruce. “As such, we recognise that Body Contouring surgery (BCS) is a crucial component of a continuum of care for post-bariatric surgery patients.”

A consultation on BCS was recently carried out and included input from BOMSS but the process is still ongoing.

Following weight-loss surgery (and all other forms of weight loss) there are predictable changes in weight and associated BMI. BOMSS is concerned that the BMI cut-off of 27 is set at a level that many successful patients may never attain. These patients often have significant functional impairment from copious excess skin, despite having a high residual BMI. It recognises that there is still uncertainty over risks and benefits of BCS at increasing BMIs but believes the threshold should be reviewed.

“Many successful bariatric surgery patients suffer from physical and psychological problems secondary to loose skin and we strongly concur with evidence which shows significant quality of life benefits following BCS,” Bruce added.

BOMSS recognises the resource implications of commissioning guidance. The distribution of resource may also be biased by this stringent guidance as many patients require more than one procedure. This mechanism of allocation may mean that some deserving patients may have no access to BCS, whilst others have access to multiple procedures. Another stance may be to increase the BMI of eligibility but place guidance on frequency of interventions.

BOMSS also recognises that it is likely that new guidance will need to stipulate a prioritisation group. It would strongly recommend that, in view of the evolving evidence in this area, there is a commitment for a timetabled review process and recommendation that resources should be developed to accommodate a likely increasing need in the near future.

As part of the ongoing process, BOMSS would like to hear views from its members, please email: info@british-obesity-surgery.org

To access the consultation document, click here

For more information, please visit BOMSS or BAPRAS

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British Obesity and Metabolic Surgery Society

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