Weight-loss surgery is changing lives in BC. According to the Richmond Bariatric Surgery program, over 80% of the patients having weight loss surgery will maintain their weight loss. Not only is it changing lives, it is also saving lives and saving medical system burdens by reducing and eliminating obesity-associated diseases and health conditions (such as diabetes, sleep apnea, joint replacement, etc.).
There are two parts to treatment for extreme weight loss. The first part is losing the weight through either Bariatric Surgery or other means. The second is the removal of excess skin after the extreme weight loss. What we believe is missing from BC’s Obesity Management plan is MSP coverage and availability of part two, skin reconstructive surgery.
After a massive weight loss (at least 100 pounds), there remains an enormous amount of excess skin. You are left with large pockets of excess skin on thighs, upper arms, buttocks, breasts, abdomen, etc. Skin that, no matter how much you exercise or how much moisturizer you use, will never shrink back to its original size and shape. Not only can it be unsightly and difficult to deal with psychologically, it can also be associated with chronic infection, skin irritation, ulcers, and cellulitis. When exercising, excess skin on the upper arms, thighs, breasts and abdomen chafe: causing pain, bleeding and chronic irritation. This also makes it possible for super bugs such as c-diff and MSRP to cause potential –and life-threatening–problems. Personal hygiene is a major issue as it becomes very difficult to clean and dry some parts of your body because of the multitude of skin folds and creases. Carrying the weight of the excess skin also has an impact on your back, hips and knees, causing joint breakdown, discomfort, and pain.
Research has shown that the cost of reconstructive surgery can be as high as $50,000 in Canada. Often, this cost is borne by the patient. For most, this cost is prohibitive (and it’s also in addition to the not-insignificant costs of having to replace an entire wardrobe (sometimes more than once) through the weight loss period). Many people either choose risky medical tourism outside the country to such places as Mexico, South America, or the Dominican Republic, or they choose to suffer in silence.
Under BC’s current legislation, some reconstructive surgery is covered. However, it only deals with the front portion of the abdomen. This procedure is known as a Panniculectomy. If a patient meets the appropriate criteria, the Panniculectomy is covered by MSP. But, accessing even this type of surgery is almost impossible. Due to limited surgical hours available to surgeons and the process required for approval of the surgery by MSP, it is difficult, if not impossible, to find a surgeon willing to perform the procedure under MSP. Wait times can be up to two years. Two years of health complications, physical and psychological discomfort: situations and feelings that can even lead to weight regain.
We are proposing that at the time a morbidly obese person is approved for surgery (part one of the process), they should also be approved for skin reconstruction (part two) with a referral from their medical practitioner. (Such a referral could be recommended –or rescinded– by any of the health professionals involved in the process as outlined next.)
In the current Bariatric Surgery program, the medical team of specialists and health practitioners includes a respirologist, dietician, physiologist, psychiatrist, gastroenterologist, and the bariatric surgeon. We also propose that as part of the Bariatric Surgery Program, reconstructive surgeons should also be part of the team. These surgeons, much like bariatric surgeons, would specialize in MSP-covered skin removal surgeries and have appropriate access to operating rooms to carry out this surgery.
Because of the many complications associated with excess skin, we believe it is important to include skin reconstruction surgery as part of BC’s obesity management plan, as many other provinces in Canada have done.
Please sign this petition to urge the BC government to add complete skin reconstruction under MSP as part of the Morbid Obesity Management plan.