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Improving equity of access to a publicly funded bariatric surgery programme by removal of mandatory weight loss targets

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From Māori Health Review Issue 112
Authors:
  • Gower A et al.
Summary:

Elimination of preoperative weight loss targets improves access to bariatric surgery for Māori and Pacific patients, according to an analysis of patients who underwent this surgery at Auckland City Hospital between 2018 and 2021. Patients (n = 200) were retrospectively compared with a group of 100 patients who had been required to lose 10% of excess body weight prior to surgery. Elimination of weight loss targets was associated with greater numbers of Māori and Pacific patients undergoing bariatric surgery, but had no significant effect on weight loss outcomes or postoperative complications.

Comment:
Firstly, we should acknowledge that these studies build on the excellent mahi of Māori and Pacific Admission Scheme (MAPAS) graduate and award-winning Dr Jamie-Lee Rahiri (Ngāti Porou, Te Atihaunui-a-Pāpārangi me Ngāti Whātua ki Kaipara). You can view her thesis here. Second, these papers confirm Jamie-Lee’s findings – inequities for Māori to access bariatric surgery are not explained by ‘patient’ factors and are instead associated with institutionally set, non-evidence based, criteria. Let’s be better.
Reference: Obes Surg. 2024;34(9):3459-3466.
Abstract
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Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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