The Federal Centre of Expertise for Healthcare (KCE) recommends that obesity surgery among youth under 18 be practiced only "in case of absolute medical necessity" and that the reimbursement of such interventions "remain quite exceptional," it said in a report released on Thursday.
Meanwhile, obesity is increasing worldwide and concerns 3 to 5% of Belgium’s children and adolescents.
Obesity surgery, also known as "bariatric and metabolic surgery", is reimbursed by Belgian health insurance since 2007 for adults with a body mass index (BMI) of at least 40 (morbid obesity), or 35 (severely obese) if the person has type 2 diabetes.
However, health authorities are considering the expansion of the reimbursement of such procedure to other target groups, including young people under 18. Which is why the KCE was to examine, in collaboration with the Inter-Mutual Agency, the efficacy, risks and complications, and cost-effectiveness of these surgical operations.
"For the majority of surgical patients, bariatric surgery allows (...) to lose almost 18 kilos more than from a non-surgical treatment during the first year and up to 28 kilograms after two years," it would seem, in particular from the KCE analysis.
In 2016, more than 13,000 weight-loss operations were performed in Belgium, an increase of over 80% over the last seven years.
Teenagers represent 3 to 5% of the patients. They are mostly between 16 and 17 years old with severe or morbid obesity, often associated with high blood pressure or diabetes.
"Bariatric surgery allows young people similar weight losses as for adults. We must be careful, however, in this regard because there are not many good quality studies on these and it is from international data from specialized hospitals, which is not necessarily applicable to less experienced teams," KCE noted, underlining that such procedures were performed on adolescents who had (almost) finished growing.
"The reimbursement of bariatric surgery for adolescents should remain quite exceptional. As long as there is no reliable scientific evidence for this type of patients, these operations should be performed only in the case of a major medical need, by multidisciplinary teams and in specialized centres," KCE insisted.
The Brussels Times