Stomach stapling surgery is one of the most successful methods for long-term weight loss in obese people but the procedure is becoming harder to get in Canada.

A new study comparing weight-loss methods concluded bariatric, or stomach stapling, surgery has by far the most profound effect.

The surgery works to shrink stomachs. Weight loss then improves health by lowering incidence of Type 2 diabetes, high blood pressure and heart attacks in obese people.

Traci Bell

In Canada, most provincial health plans pay for the surgery. Demand is high, but supply is low. In the past two years, seven centres, including ones in Vancouver, London and Ottawa, have stopped performing the procedure.

Traci Bell of Edmonton was 100 pounds overweight with three health problems, all weight-related conditions. She was able to get weight-loss surgery after 20 years of diets and exercise failed to keep the extra pounds off.

"I wake up choking in the middle of the night because I can't get my breath because of the fat around my neck," she said in July 2002.

Dr. James Douketis

Eighteen months later and 65 pounds lighter, her blood pressure and blood sugar are normal and the breathing problems are gone. "It's given me life back," Bell said.

But Bell's doctor isn't taking new patients. Only 11 Canadian hospitals continue to offer weight-loss surgery, and many do no more than one or two a week.

Weight-loss surgeon Dr. Doug Davy says the programs have been cut because the procedure is expensive and time consuming, with a high rate of complications. Health-care administrators may see the condition as self-afflicted due to a lack of willpower, making it an easy program to cut when funds are tight.

"I think the answer to the administrators is you pay now or you pay later," said Davy. "It's going to get a lot harder later, because these people aren't going to go away."

Waiting lists for some surgeons can top six years. One doctor in Montreal said he has more than 1,300 people lined up. Some can't work, can barely walk and most suffer a wide-range of weight-related illnesses.

Internist Dr. James Douketis at McMaster University in Hamilton doesn't shrink stomachs, but his research backs up its value.

"The surgical methods of weight reduction were the most effective in terms of weight loss, where typically you get 25 to 50 kilogram weight loss over a two to four year period," said Douketis.