obeseoldNICE has published an updated draft of its guidance on obesity, which will be available for consultation from today. It includes recommendations on weight loss surgery for people with type 2 diabetes and proposes that very-low calorie diets should be used more selectively.

NICE is updating its guideline on the identification, assessment and management of overweight and obesity.

Simon O’Neill, Director of Health Intelligence and Professional Liaison at Diabetes UK, said: “For most people, losing weight can be very difficult. For some, as well as a healthy diet and physical activity, additional treatments include medication and surgery. Although studies have shown that bariatric surgery can help with weight loss and have a positive effect on blood glucose levels, it must be remembered that any surgery carries serious risks. Bariatric surgery should only be considered if serious attempts to lose weight have been unsuccessful and if the person is obese.

“Bariatric surgery can lead to dramatic weight loss, which in turn may result in a reduction in people taking their Type 2 diabetes medication and even in some people needing no medication at all. This does not mean, however, that Type 2 diabetes has been cured. These people will still need to eat a healthy balanced diet and be physically active to manage their diabetes. We hope our research into very low-calorie diets will show whether these can be maintained in the long term"

The surgery can cost between £3,000 and £15,000 and the move by NICE has raised concerns that the NHS will not be able to afford the treatment, even if there are savings in the longer term.

Current guidance says surgery is an option for people with a BMI above 35 who have other health conditions.