Professor Helen Henehan

Yes, David, and I guess the reason people feel the need to travel abroad for surgery is the delay or the lack of access to services here.

So, you know, obesity treatment services have been grossly underfunded for decades in Ireland and the legacy of that is a very lengthy waiting list for treatment now.

So whilst we do have excellent, high quality services, certainly for obesity care in Dublin and in Galway,

It's not enough to meet the demand such as the prevalence of obesity around the country.

So I understand why people feel the need to go abroad.

And similarly, if people are to seek surgery privately here and to self pay for it, it is more expensive.

But that does reflect the quality of care that patients would receive here.

So that has changed over the last three to four years, David.

So when, and Alan might speak to this, the time Alan went abroad for surgery just after COVID and there was a surge of people travelling then.

As a result of what Professor McNamara mentioned, really direct and targeted aggressive advertising to patients when they had time, they were at home and could travel.

Despite the travel restrictions and lockdowns, people were allowed to go for medical procedures.

So there was a surge there where we were seeing back two to three patients a week in certainly our hospital in St.

Vincent's.

And that happened around the country with complications such as leak, bleeding.

complications and leading to sepsis and that has changed the pattern of complications we're seeing now is related is is later complications so people who've had sleeve gastrectomy and now have bad reflux as a result some people are regaining weight and some people have malnutrition because they didn't really have any they have no follow-up care no wraparound care that's so important to the success of bariatric surgery okay um i want to bring alan kyo in alan good morning to you

Certainly there are other weight loss treatments and as everybody will be familiar with GLP-1 drugs at the minute like Ozempic, Manjaro and they are excellent treatments.

I suppose the problem with them is when people have the severity of obesity, Alan had a 270 kilos, you sometimes need multiple treatments.

So the medications on their own are unlikely to achieve enough of a result to lead to significant health improvements and weight loss treatments.

Bariatric surgery on its own is a more powerful treatment that will lead to a more durable result with meds.

They're very expensive.