Experts Urge Regulation of Bariatric Surgery Medical Tourism

Medical tourism focused on bariatric and weight-reduction surgery is experiencing a surge, prompting calls for urgent regulation to safeguard the health of patients traveling abroad for these procedures. A recent commentary published in BMJ Global Health highlights the growing trend and associated risks as the demand for obesity treatment continues to rise, particularly in light of rising healthcare costs and the increasing availability of services.

Dr. Jessica McGirr from the Obesity Research and Care Group at RCSI University of Medicine and Health Sciences, along with colleagues, emphasizes that while the medical tourism industry is expanding rapidly, it remains largely unregulated. The global medical tourism market is valued at over $400 billion, with a projected annual growth rate of 25%. Despite the introduction of weight loss medications, there is no sign of a decrease in the number of individuals seeking bariatric surgery abroad, often due to significantly lower costs in countries like Turkey, where procedures can range from £2,500 to £4,500, compared to £10,000 to £15,000 in the UK.

A comprehensive survey on bariatric surgery providers indicates that 71% of patients self-refer for these procedures. This raises concerns about whether these individuals have a genuine medical necessity for surgery, as many cite ineligibility for such operations in their home countries as a primary reason for seeking treatment abroad.

However, opting for surgery in a foreign country can come with various risks. The lack of clarity regarding complication rates, inadequate preoperative and long-term follow-up, and the absence of a multidisciplinary care team can jeopardize patient safety. The commentary warns that serious adverse outcomes, including surgical complications like anastomotic leakage and sepsis, are potential risks that patients may not fully understand.

Additionally, there are ethical concerns regarding the consent process for these procedures. A survey revealed that nearly a third of providers felt the consent process was inappropriate, and 14% believed that patients should bear personal responsibility for any surgical complications that arise.

Experts argue that regulating the bariatric and metabolic tourism sector is essential to mitigate these safety, ethical, and legal risks. The financial burden of treating postoperative complications, both for returning medical tourists and in countries offering these surgeries, raises further ethical questions about the prioritization of private sector profits over public health.

The authors advocate for international collaboration to establish regulations governing this industry, suggesting that organizations such as the World Trade Organization, the World Health Organization, and the European Union should spearhead efforts to create a global regulatory framework. They conclude by emphasizing that while medical tourism presents opportunities for quicker access to effective obesity treatments, the accompanying risks must be addressed to ensure patient safety and equity in healthcare.