Tag Archives: Risk

Obesity surgery ‘halves risk of death’ compared with lifestyle changes

Latest study lends support to experts who say more operations should be carried out in UK

Bariatric surgery reduces the size of the patient’s stomach. It is cost-effective and leads to substantial weight-loss as well as helping to tackle type 2 diabetes.


Bariatric surgery reduces the size of the patient’s stomach. It is cost-effective and leads to substantial weight-loss as well as helping to tackle type 2 diabetes. Photograph: Murdo Macleod for the Guardian

Obese patients undergoing stomach-shrinking surgery have half the risk of death in the years that follow compared with those tackling their weight through diet and behaviour alone, new research suggests.

Experts say obesity surgery is cost-effective, leads to substantial weight loss and can help tackle type 2 diabetes. But surgeons say not enough of the stomach-shrinking surgeries are carried out in the UK, with figures currently lagging behind other European countries, including France and Belgium – despite the latter having a smaller population.

“We don’t think this [new study] alone is sufficient to conclude that obese patients should push for bariatric surgery, but this additional information certainly seems to provide additional support,” said Philip Greenland, co-author of the latest study from Northwestern University.

Q&A

Share your experiences of obesity surgery

If you have had stomach-shrinking surgery we would like to hear from you. What was your experience like? Did you find the procedure helpful or not?

You can share your story using our encrypted form here. We will feature some of your contributions in our reporting.

In the new study, one of several on obesity surgery published in the Journal of the American Medical Association, researchers sought to explore whether stomach-shrinking operations, known as bariatric surgery, had a long-term impact on the risk of death among obese individuals, compared with non-surgical approaches to weight loss.

In total, more than 33,500 participants were involved in the study – 8,385 of whom had one of three types of bariatric surgery between 2005 and 2014. The majority of participants had a BMI greater than 35; obesity is defined as a BMI of 30 or higher.

The researchers followed up the participants over the years that followed their surgery until death, or the end of the follow-up period in December 2015, comparing the number of deaths and other metrics with those for obese patients who had not had surgery but were given dietary and behavioural help. Each surgery patient was compared to three who did not have surgery, but had similar characteristics such as age and sex, and were also followed until they too had surgery, died or the study ended.

The results reveal that the death rate during the study was 1.3% for those who had any form of bariatric surgery, while among those who had not had surgery it was 2.3%, although the length of follow-up period varied considerably from patient to patient.

Once other factors including age, sex and related diseases were taken into account, the team found those who did not have stomach-shrinking surgery had just over twice the risk of death compared to those who had, with all three types of surgery linked to lower mortality.

What’s more, the group which had surgery showed a greater reduction in BMI, lower rates of new diabetes diagnoses, improved blood pressure, and a greater proportion of diabetic individuals going into remission.

But the team add that a small proportion of surgery patients required further surgery, while they note the study was observational so cannot prove bariatric surgery itself reduced the risk of death since patients were not randomised, meaning it is possible that those who did not have surgery were in poorer health.

A second, smaller study in the same journal also highlighted benefits of bariatric surgery, comparing diabetes-related markers in obese adults who had lived with a diagnosis of type 2 diabetes for an average of nine years. Participants either received two years of intensive diet, exercise and medical management or, in addition, had bariatric surgery.

The results from 113 participants reveal that complications were more common among those who had had bariatric surgery, but that one year after the study began they had lost more weight on average, with a greater proportion having reached the combined targets for cholesterol, systolic blood pressure and a marker of glucose.

While this proportion fell for both groups after five years – at which point 98 patients were still providing data – those who had had bariatric surgery maintained the edge, with 23% reaching the combined targets, compared to just 4% of those offered lifestyle and medical interventions alone.

Francesco Rubino, professor of metabolic and bariatric surgery at King’s College London, who was not involved in the studies, said misunderstandings and stigma were holding back greater use of such operations in the UK. While Rubino noted that surgery is not for everyone, he added “This is a conversation GPs and doctors should have with patients more often.”

Obesity surgery ‘halves risk of death’ compared with lifestyle changes

Latest study lends support to experts who say more operations should be carried out in UK

Bariatric surgery reduces the size of the patient’s stomach. It is cost-effective and leads to substantial weight-loss as well as helping to tackle type 2 diabetes.


Bariatric surgery reduces the size of the patient’s stomach. It is cost-effective and leads to substantial weight-loss as well as helping to tackle type 2 diabetes. Photograph: Murdo Macleod for the Guardian

Obese patients undergoing stomach-shrinking surgery have half the risk of death in the years that follow compared with those tackling their weight through diet and behaviour alone, new research suggests.

Experts say obesity surgery is cost-effective, leads to substantial weight loss and can help tackle type 2 diabetes. But surgeons say not enough of the stomach-shrinking surgeries are carried out in the UK, with figures currently lagging behind other European countries, including France and Belgium – despite the latter having a smaller population.

“We don’t think this [new study] alone is sufficient to conclude that obese patients should push for bariatric surgery, but this additional information certainly seems to provide additional support,” said Philip Greenland, co-author of the latest study from Northwestern University.

Q&A

Share your experiences of obesity surgery

If you have had stomach-shrinking surgery we would like to hear from you. What was your experience like? Did you find the procedure helpful or not?

You can share your story using our encrypted form here. We will feature some of your contributions in our reporting.

In the new study, one of several on obesity surgery published in the Journal of the American Medical Association, researchers sought to explore whether stomach-shrinking operations, known as bariatric surgery, had a long-term impact on the risk of death among obese individuals, compared with non-surgical approaches to weight loss.

In total, more than 33,500 participants were involved in the study – 8,385 of whom had one of three types of bariatric surgery between 2005 and 2014. The majority of participants had a BMI greater than 35; obesity is defined as a BMI of 30 or higher.

The researchers followed up the participants over the years that followed their surgery until death, or the end of the follow-up period in December 2015, comparing the number of deaths and other metrics with those for obese patients who had not had surgery but were given dietary and behavioural help. Each surgery patient was compared to three who did not have surgery, but had similar characteristics such as age and sex, and were also followed until they too had surgery, died or the study ended.

The results reveal that the death rate during the study was 1.3% for those who had any form of bariatric surgery, while among those who had not had surgery it was 2.3%, although the length of follow-up period varied considerably from patient to patient.

Once other factors including age, sex and related diseases were taken into account, the team found those who did not have stomach-shrinking surgery had just over twice the risk of death compared to those who had, with all three types of surgery linked to lower mortality.

What’s more, the group which had surgery showed a greater reduction in BMI, lower rates of new diabetes diagnoses, improved blood pressure, and a greater proportion of diabetic individuals going into remission.

But the team add that a small proportion of surgery patients required further surgery, while they note the study was observational so cannot prove bariatric surgery itself reduced the risk of death since patients were not randomised, meaning it is possible that those who did not have surgery were in poorer health.

A second, smaller study in the same journal also highlighted benefits of bariatric surgery, comparing diabetes-related markers in obese adults who had lived with a diagnosis of type 2 diabetes for an average of nine years. Participants either received two years of intensive diet, exercise and medical management or, in addition, had bariatric surgery.

The results from 113 participants reveal that complications were more common among those who had had bariatric surgery, but that one year after the study began they had lost more weight on average, with a greater proportion having reached the combined targets for cholesterol, systolic blood pressure and a marker of glucose.

While this proportion fell for both groups after five years – at which point 98 patients were still providing data – those who had had bariatric surgery maintained the edge, with 23% reaching the combined targets, compared to just 4% of those offered lifestyle and medical interventions alone.

Francesco Rubino, professor of metabolic and bariatric surgery at King’s College London, who was not involved in the studies, said misunderstandings and stigma were holding back greater use of such operations in the UK. While Rubino noted that surgery is not for everyone, he added “This is a conversation GPs and doctors should have with patients more often.”

Obesity surgery ‘halves risk of death’ compared with lifestyle changes

Latest study lends support to experts who say more operations should be carried out in UK

Bariatric surgery reduces the size of the patient’s stomach. It is cost-effective and leads to substantial weight-loss as well as helping to tackle type 2 diabetes.


Bariatric surgery reduces the size of the patient’s stomach. It is cost-effective and leads to substantial weight-loss as well as helping to tackle type 2 diabetes. Photograph: Murdo Macleod for the Guardian

Obese patients undergoing stomach-shrinking surgery have half the risk of death in the years that follow compared with those tackling their weight through diet and behaviour alone, new research suggests.

Experts say obesity surgery is cost-effective, leads to substantial weight loss and can help tackle type 2 diabetes. But surgeons say not enough of the stomach-shrinking surgeries are carried out in the UK, with figures currently lagging behind other European countries, including France and Belgium – despite the latter having a smaller population.

“We don’t think this [new study] alone is sufficient to conclude that obese patients should push for bariatric surgery, but this additional information certainly seems to provide additional support,” said Philip Greenland, co-author of the latest study from Northwestern University.

Q&A

Share your experiences of obesity surgery

If you have had stomach-shrinking surgery we would like to hear from you. What was your experience like? Did you find the procedure helpful or not?

You can share your story using our encrypted form here. We will feature some of your contributions in our reporting.

In the new study, one of several on obesity surgery published in the Journal of the American Medical Association, researchers sought to explore whether stomach-shrinking operations, known as bariatric surgery, had a long-term impact on the risk of death among obese individuals, compared with non-surgical approaches to weight loss.

In total, more than 33,500 participants were involved in the study – 8,385 of whom had one of three types of bariatric surgery between 2005 and 2014. The majority of participants had a BMI greater than 35; obesity is defined as a BMI of 30 or higher.

The researchers followed up the participants over the years that followed their surgery until death, or the end of the follow-up period in December 2015, comparing the number of deaths and other metrics with those for obese patients who had not had surgery but were given dietary and behavioural help. Each surgery patient was compared to three who did not have surgery, but had similar characteristics such as age and sex, and were also followed until they too had surgery, died or the study ended.

The results reveal that the death rate during the study was 1.3% for those who had any form of bariatric surgery, while among those who had not had surgery it was 2.3%, although the length of follow-up period varied considerably from patient to patient.

Once other factors including age, sex and related diseases were taken into account, the team found those who did not have stomach-shrinking surgery had just over twice the risk of death compared to those who had, with all three types of surgery linked to lower mortality.

What’s more, the group which had surgery showed a greater reduction in BMI, lower rates of new diabetes diagnoses, improved blood pressure, and a greater proportion of diabetic individuals going into remission.

But the team add that a small proportion of surgery patients required further surgery, while they note the study was observational so cannot prove bariatric surgery itself reduced the risk of death since patients were not randomised, meaning it is possible that those who did not have surgery were in poorer health.

A second, smaller study in the same journal also highlighted benefits of bariatric surgery, comparing diabetes-related markers in obese adults who had lived with a diagnosis of type 2 diabetes for an average of nine years. Participants either received two years of intensive diet, exercise and medical management or, in addition, had bariatric surgery.

The results from 113 participants reveal that complications were more common among those who had had bariatric surgery, but that one year after the study began they had lost more weight on average, with a greater proportion having reached the combined targets for cholesterol, systolic blood pressure and a marker of glucose.

While this proportion fell for both groups after five years – at which point 98 patients were still providing data – those who had had bariatric surgery maintained the edge, with 23% reaching the combined targets, compared to just 4% of those offered lifestyle and medical interventions alone.

Francesco Rubino, professor of metabolic and bariatric surgery at King’s College London, who was not involved in the studies, said misunderstandings and stigma were holding back greater use of such operations in the UK. While Rubino noted that surgery is not for everyone, he added “This is a conversation GPs and doctors should have with patients more often.”

Obesity surgery ‘halves risk of death’ compared to lifestyle changes alone

Latest study of long-term impact of bariatric surgery lends support to experts who say more operations should be carried out in UK

Bariatric surgery reduces the size of the patient’s stomach. It is cost-effective and leads to substantial weight-loss as well as helping to tackle type 2 diabetes.


Bariatric surgery reduces the size of the patient’s stomach. It is cost-effective and leads to substantial weight-loss as well as helping to tackle type 2 diabetes. Photograph: Murdo Macleod for the Guardian

Obese patients undergoing stomach-shrinking surgery have half the risk of death in the years that follow compared with those tackling their weight through diet and behaviour alone, new research suggests.

Experts say obesity surgery is cost-effective, leads to substantial weight loss and can help tackle type 2 diabetes. But surgeons say not enough of the stomach-shrinking surgeries are carried out in the UK, with figures currently lagging behind other European countries, including France and Belgium – despite the latter having a smaller population.

“We don’t think this [new study] alone is sufficient to conclude that obese patients should push for bariatric surgery, but this additional information certainly seems to provide additional support,” said Philip Greenland, co-author of the latest study from Northwestern University.

Q&A

Share your experiences of obesity surgery

If you have had stomach-shrinking surgery we would like to hear from you. What was your experience like? Did you find the procedure helpful or not?

You can share your story using our encrypted form here. We will feature some of your contributions in our reporting.

In the new study, one of several on obesity surgery published in the Journal of the American Medical Association, researchers sought to explore whether stomach-shrinking operations, known as bariatric surgery, had a long-term impact on the risk of death among obese individuals, compared with non-surgical approaches to weight loss.

In total, more than 33,500 participants were involved in the study – 8,385 of whom had one of three types of bariatric surgery between 2005 and 2014. The majority of participants had a BMI greater than 35; obesity is defined as a BMI of 30 or higher.

The researchers followed up the participants over the years that followed their surgery until death, or the end of the follow-up period in December 2015, comparing the number of deaths and other metrics with those for obese patients who had not had surgery but were given dietary and behavioural help. Each surgery patient was compared to three who did not have surgery, but had similar characteristics such as age and sex, and were also followed until they too had surgery, died or the study ended.

The results reveal that the death rate during the study was 1.3% for those who had any form of bariatric surgery, while among those who had not had surgery it was 2.3%, although the length of follow-up period varied considerably from patient to patient.

Once other factors including age, sex and related diseases were taken into account, the team found those who did not have stomach-shrinking surgery had just over twice the risk of death compared to those who had, with all three types of surgery linked to lower mortality.

What’s more, the group which had surgery showed a greater reduction in BMI, lower rates of new diabetes diagnoses, improved blood pressure, and a greater proportion of diabetic individuals going into remission.

But the team add that a small proportion of surgery patients required further surgery, while they note the study was observational so cannot prove bariatric surgery itself reduced the risk of death since patients were not randomised, meaning it is possible that those who did not have surgery were in poorer health.

A second, smaller study in the same journal also highlighted benefits of bariatric surgery, comparing diabetes-related markers in obese adults who had lived with a diagnosis of type 2 diabetes for an average of nine years. Participants either received two years of intensive diet, exercise and medical management or, in addition, had bariatric surgery.

The results from 113 participants reveal that complications were more common among those who had had bariatric surgery, but that one year after the study began they had lost more weight on average, with a greater proportion having reached the combined targets for cholesterol, systolic blood pressure and a marker of glucose.

While this proportion fell for both groups after five years – at which point 98 patients were still providing data – those who had had bariatric surgery maintained the edge, with 23% reaching the combined targets, compared to just 4% of those offered lifestyle and medical interventions alone.

Francesco Rubino, professor of metabolic and bariatric surgery at King’s College London, who was not involved in the studies, said misunderstandings and stigma were holding back greater use of such operations in the UK. While Rubino noted that surgery is not for everyone, he added “This is a conversation GPs and doctors should have with patients more often.”

Obesity surgery ‘halves risk of death’ compared to lifestyle changes alone

Latest study of long-term impact of bariatric surgery lends support to experts who say more operations should be carried out in UK

Bariatric surgery reduces the size of the patient’s stomach. It is cost-effective and leads to substantial weight-loss as well as helping to tackle type 2 diabetes.


Bariatric surgery reduces the size of the patient’s stomach. It is cost-effective and leads to substantial weight-loss as well as helping to tackle type 2 diabetes. Photograph: Murdo Macleod for the Guardian

Obese patients undergoing stomach-shrinking surgery have half the risk of death in the years that follow compared with those tackling their weight through diet and behaviour alone, new research suggests.

Experts say obesity surgery is cost-effective, leads to substantial weight loss and can help tackle type 2 diabetes. But surgeons say not enough of the stomach-shrinking surgeries are carried out in the UK, with figures currently lagging behind other European countries, including France and Belgium – despite the latter having a smaller population.

“We don’t think this [new study] alone is sufficient to conclude that obese patients should push for bariatric surgery, but this additional information certainly seems to provide additional support,” said Philip Greenland, co-author of the latest study from Northwestern University.

Q&A

Share your experiences of obesity surgery

If you have had stomach-shrinking surgery we would like to hear from you. What was your experience like? Did you find the procedure helpful or not?

You can share your story using our encrypted form here. We will feature some of your contributions in our reporting.

In the new study, one of several on obesity surgery published in the Journal of the American Medical Association, researchers sought to explore whether stomach-shrinking operations, known as bariatric surgery, had a long-term impact on the risk of death among obese individuals, compared with non-surgical approaches to weight loss.

In total, more than 33,500 participants were involved in the study – 8,385 of whom had one of three types of bariatric surgery between 2005 and 2014. The majority of participants had a BMI greater than 35; obesity is defined as a BMI of 30 or higher.

The researchers followed up the participants over the years that followed their surgery until death, or the end of the follow-up period in December 2015, comparing the number of deaths and other metrics with those for obese patients who had not had surgery but were given dietary and behavioural help. Each surgery patient was compared to three who did not have surgery, but had similar characteristics such as age and sex, and were also followed until they too had surgery, died or the study ended.

The results reveal that the death rate during the study was 1.3% for those who had any form of bariatric surgery, while among those who had not had surgery it was 2.3%, although the length of follow-up period varied considerably from patient to patient.

Once other factors including age, sex and related diseases were taken into account, the team found those who did not have stomach-shrinking surgery had just over twice the risk of death compared to those who had, with all three types of surgery linked to lower mortality.

What’s more, the group which had surgery showed a greater reduction in BMI, lower rates of new diabetes diagnoses, improved blood pressure, and a greater proportion of diabetic individuals going into remission.

But the team add that a small proportion of surgery patients required further surgery, while they note the study was observational so cannot prove bariatric surgery itself reduced the risk of death since patients were not randomised, meaning it is possible that those who did not have surgery were in poorer health.

A second, smaller study in the same journal also highlighted benefits of bariatric surgery, comparing diabetes-related markers in obese adults who had lived with a diagnosis of type 2 diabetes for an average of nine years. Participants either received two years of intensive diet, exercise and medical management or, in addition, had bariatric surgery.

The results from 113 participants reveal that complications were more common among those who had had bariatric surgery, but that one year after the study began they had lost more weight on average, with a greater proportion having reached the combined targets for cholesterol, systolic blood pressure and a marker of glucose.

While this proportion fell for both groups after five years – at which point 98 patients were still providing data – those who had had bariatric surgery maintained the edge, with 23% reaching the combined targets, compared to just 4% of those offered lifestyle and medical interventions alone.

Francesco Rubino, professor of metabolic and bariatric surgery at King’s College London, who was not involved in the studies, said misunderstandings and stigma were holding back greater use of such operations in the UK. While Rubino noted that surgery is not for everyone, he added “This is a conversation GPs and doctors should have with patients more often.”

Obesity surgery ‘halves risk of death’ compared to lifestyle changes alone

Latest study of long-term impact of bariatric surgery lends support to experts who say more operations should be carried out in UK

Bariatric surgery reduces the size of the patient’s stomach. It is cost-effective and leads to substantial weight-loss as well as helping to tackle type 2 diabetes.


Bariatric surgery reduces the size of the patient’s stomach. It is cost-effective and leads to substantial weight-loss as well as helping to tackle type 2 diabetes. Photograph: Murdo Macleod for the Guardian

Obese patients undergoing stomach-shrinking surgery have half the risk of death in the years that follow compared with those tackling their weight through diet and behaviour alone, new research suggests.

Experts say obesity surgery is cost-effective, leads to substantial weight loss and can help tackle type 2 diabetes. But surgeons say not enough of the stomach-shrinking surgeries are carried out in the UK, with figures currently lagging behind other European countries, including France and Belgium – despite the latter having a smaller population.

“We don’t think this [new study] alone is sufficient to conclude that obese patients should push for bariatric surgery, but this additional information certainly seems to provide additional support,” said Philip Greenland, co-author of the latest study from Northwestern University.

In the new study, one of several on obesity surgery published in the Journal of the American Medical Association, researchers sought to explore whether stomach-shrinking operations, known as bariatric surgery, had a long-term impact on the risk of death among obese individuals, compared with non-surgical approaches to weight loss.

In total, more than 33,500 participants were involved in the study – 8,385 of whom had one of three types of bariatric surgery between 2005 and 2014. The majority of participants had a BMI greater than 35; obesity is defined as a BMI of 30 or higher.

The researchers followed up the participants over the years that followed their surgery until death, or the end of the follow-up period in December 2015, comparing the number of deaths and other metrics with those for obese patients who had not had surgery but were given dietary and behavioural help. Each surgery patient was compared to three who did not have surgery, but had similar characteristics such as age and sex, and were also followed until they too had surgery, died or the study ended.

The results reveal that the death rate during the study was 1.3% for those who had any form of bariatric surgery, while among those who had not had surgery it was 2.3%, although the length of follow-up period varied considerably from patient to patient.

Once other factors including age, sex and related diseases were taken into account, the team found those who did not have stomach-shrinking surgery had just over twice the risk of death compared to those who had, with all three types of surgery linked to lower mortality.

What’s more, the group which had surgery showed a greater reduction in BMI, lower rates of new diabetes diagnoses, improved blood pressure, and a greater proportion of diabetic individuals going into remission.

But the team add that a small proportion of surgery patients required further surgery, while they note the study was observational so cannot prove bariatric surgery itself reduced the risk of death since patients were not randomised, meaning it is possible that those who did not have surgery were in poorer health.

A second, smaller study in the same journal also highlighted benefits of bariatric surgery, comparing diabetes-related markers in obese adults who had lived with a diagnosis of type 2 diabetes for an average of nine years. Participants either received two years of intensive diet, exercise and medical management or, in addition, had bariatric surgery.

The results from 113 participants reveal that complications were more common among those who had had bariatric surgery, but that one year after the study began they had lost more weight on average, with a greater proportion having reached the combined targets for cholesterol, systolic blood pressure and a marker of glucose.

While this proportion fell for both groups after five years – at which point 98 patients were still providing data – those who had had bariatric surgery maintained the edge, with 23% reaching the combined targets, compared to just 4% of those offered lifestyle and medical interventions alone.

Francesco Rubino, professor of metabolic and bariatric surgery at King’s College London, who was not involved in the studies, said misunderstandings and stigma were holding back greater use of such operations in the UK. While Rubino noted that surgery is not for everyone, he added “This is a conversation GPs and doctors should have with patients more often.”

Changes to EU working rules will ‘put patients’ lives at risk’, say medics

Representatives of British doctors, psychiatrists and nursing staff have warned that weakening working time regulations as part of the Brexit process would put the lives of patients at risk.

Changes to the current EU rules on a working week, rest entitlements and paid leave in the UK, with the option of opt out, have been mooted by members of Theresa May’s cabinet when discussing their vision of post-Brexit Britain.

But leaders from the British Medical Association (BMA), along with 12 royal colleges and trade unions, have urged Theresa May to stand firm against Brexiters who want to scrap European laws, warning of risks to patient safety.

In a letter to the prime minister, medical leaders ask May to put her promises to protect British workers into pre-Brexit written guarantees to head off a simmering campaign within the cabinet, reportedly being led by environment secretary Michael Gove and other Brexiters, to relax the law.

“Twenty-five years ago, the phenomenon of health professionals working 90-hour weeks, and the attendant risks this posed, was all too common in the NHS. The worst excesses of these working arrangements were only curtailed following the arrival of EU-derived legislation limiting hours,” reads the letter from the BMA and other medical organisations.

The EU working time directive (WTR) is incorporated into UK law and protects the right to restricted hours of work, regular rest breaks, health and safety protection and paid holidays.

Medical professionals say in their letter that they are concerned patients’ safety would be put at risk if there was any diminution of the WTR.

It says that even with the EU regulations in place, “fatigue, caused by excessive overwork, remains an occupational hazard for many staff at the NHS” – a point echoed in a statement by the head of the Royal College of Nursing, a signatory to the letter.

Janet Davies, chief executive and general secretary of the RCN, said: “Nurses are driven to do the best they can for their patients, but however dedicated, clinical staff overtired from working excessive hours could become a risk to the very people they are trying to treat.

“Working time regulations put an end to the excessive hours of the past, and in doing so made care safer.

“It should be clear to the government that removing or weakening working time regulations would put patients at serious risk.”

Earlier this week, May dismissed claims that the government was planning to ditch the directive, insisting she intended to “not only maintain but also enhance workers’ rights”.

She was responding to reports that Gove and others wanted to return the power to employers and to give the “ordinary British worker” the opportunity to do more overtime and make extra money.

Other signatories to the letter are the Royal College of Emergency Medicine, Royal College of Anaesthetists, Royal College of General Practitioners, Royal College of Midwives, British Dental Association, Royal College of Opthamologists, Royal College of Paediatrics and Child Health, Royal College of Physicians, Royal College of Surgeons of Edinburgh, Royal College of Radiologists and the Royal College of Obstetricians and Gynaecologists.

The medical profession associations call on May not to renege on her promise, made at the Conservative party conference to guarantee workers’ rights in law.

Many doctors, particularly junior doctors, work more than 48 hours a week because of shift patterns, the BMA said. Many will work at least between 48 and 56 hours and many will stay over to finish paperwork or see a clinic or patient through.

Recent reporting data from within the NHS showed that one doctor in a trust in Croydon worked 81 hours in one week this year.

But the BMA says the WTR has reduced significantly the amount of incidents like this.

Changes to EU working rules will ‘put patients’ lives at risk’, say medics

Representatives of British doctors, psychiatrists and nursing staff have warned that weakening working time regulations as part of the Brexit process would put the lives of patients at risk.

Changes to the current EU rules on a working week, rest entitlements and paid leave in the UK, with the option of opt out, have been mooted by members of Theresa May’s cabinet when discussing their vision of post-Brexit Britain.

But leaders from the British Medical Association (BMA), along with 12 royal colleges and trade unions, have urged Theresa May to stand firm against Brexiters who want to scrap European laws, warning of risks to patient safety.

In a letter to the prime minister, medical leaders ask May to put her promises to protect British workers into pre-Brexit written guarantees to head off a simmering campaign within the cabinet, reportedly being led by environment secretary Michael Gove and other Brexiters, to relax the law.

“Twenty-five years ago, the phenomenon of health professionals working 90-hour weeks, and the attendant risks this posed, was all too common in the NHS. The worst excesses of these working arrangements were only curtailed following the arrival of EU-derived legislation limiting hours,” reads the letter from the BMA and other medical organisations.

The EU working time directive (WTR) is incorporated into UK law and protects the right to restricted hours of work, regular rest breaks, health and safety protection and paid holidays.

Medical professionals say in their letter that they are concerned patients’ safety would be put at risk if there was any diminution of the WTR.

It says that even with the EU regulations in place, “fatigue, caused by excessive overwork, remains an occupational hazard for many staff at the NHS” – a point echoed in a statement by the head of the Royal College of Nursing, a signatory to the letter.

Janet Davies, chief executive and general secretary of the RCN, said: “Nurses are driven to do the best they can for their patients, but however dedicated, clinical staff overtired from working excessive hours could become a risk to the very people they are trying to treat.

“Working time regulations put an end to the excessive hours of the past, and in doing so made care safer.

“It should be clear to the government that removing or weakening working time regulations would put patients at serious risk.”

Earlier this week, May dismissed claims that the government was planning to ditch the directive, insisting she intended to “not only maintain but also enhance workers’ rights”.

She was responding to reports that Gove and others wanted to return the power to employers and to give the “ordinary British worker” the opportunity to do more overtime and make extra money.

Other signatories to the letter are the Royal College of Emergency Medicine, Royal College of Anaesthetists, Royal College of General Practitioners, Royal College of Midwives, British Dental Association, Royal College of Opthamologists, Royal College of Paediatrics and Child Health, Royal College of Physicians, Royal College of Surgeons of Edinburgh, Royal College of Radiologists and the Royal College of Obstetricians and Gynaecologists.

The medical profession associations call on May not to renege on her promise, made at the Conservative party conference to guarantee workers’ rights in law.

Many doctors, particularly junior doctors, work more than 48 hours a week because of shift patterns, the BMA said. Many will work at least between 48 and 56 hours and many will stay over to finish paperwork or see a clinic or patient through.

Recent reporting data from within the NHS showed that one doctor in a trust in Croydon worked 81 hours in one week this year.

But the BMA says the WTR has reduced significantly the amount of incidents like this.

Changes to EU working rules will ‘put patients’ lives at risk’, say medics

Representatives of British doctors, psychiatrists and nursing staff have warned that weakening working time regulations as part of the Brexit process would put the lives of patients at risk.

Changes to the current EU rules on a working week, rest entitlements and paid leave in the UK, with the option of opt out, have been mooted by members of Theresa May’s cabinet when discussing their vision of post-Brexit Britain.

But leaders from the British Medical Association (BMA), along with 12 royal colleges and trade unions, have urged Theresa May to stand firm against Brexiters who want to scrap European laws, warning of risks to patient safety.

In a letter to the prime minister, medical leaders ask May to put her promises to protect British workers into pre-Brexit written guarantees to head off a simmering campaign within the cabinet, reportedly being led by environment secretary Michael Gove and other Brexiters, to relax the law.

“Twenty-five years ago, the phenomenon of health professionals working 90-hour weeks, and the attendant risks this posed, was all too common in the NHS. The worst excesses of these working arrangements were only curtailed following the arrival of EU-derived legislation limiting hours,” reads the letter from the BMA and other medical organisations.

The EU working time directive (WTR) is incorporated into UK law and protects the right to restricted hours of work, regular rest breaks, health and safety protection and paid holidays.

Medical professionals say in their letter that they are concerned patients’ safety would be put at risk if there was any diminution of the WTR.

It says that even with the EU regulations in place, “fatigue, caused by excessive overwork, remains an occupational hazard for many staff at the NHS” – a point echoed in a statement by the head of the Royal College of Nursing, a signatory to the letter.

Janet Davies, chief executive and general secretary of the RCN, said: “Nurses are driven to do the best they can for their patients, but however dedicated, clinical staff overtired from working excessive hours could become a risk to the very people they are trying to treat.

“Working time regulations put an end to the excessive hours of the past, and in doing so made care safer.

“It should be clear to the government that removing or weakening working time regulations would put patients at serious risk.”

Earlier this week, May dismissed claims that the government was planning to ditch the directive, insisting she intended to “not only maintain but also enhance workers’ rights”.

She was responding to reports that Gove and others wanted to return the power to employers and to give the “ordinary British worker” the opportunity to do more overtime and make extra money.

Other signatories to the letter are the Royal College of Emergency Medicine, Royal College of Anaesthetists, Royal College of General Practitioners, Royal College of Midwives, British Dental Association, Royal College of Opthamologists, Royal College of Paediatrics and Child Health, Royal College of Physicians, Royal College of Surgeons of Edinburgh, Royal College of Radiologists and the Royal College of Obstetricians and Gynaecologists.

The medical profession associations call on May not to renege on her promise, made at the Conservative party conference to guarantee workers’ rights in law.

Many doctors, particularly junior doctors, work more than 48 hours a week because of shift patterns, the BMA said. Many will work at least between 48 and 56 hours and many will stay over to finish paperwork or see a clinic or patient through.

Recent reporting data from within the NHS showed that one doctor in a trust in Croydon worked 81 hours in one week this year.

But the BMA says the WTR has reduced significantly the amount of incidents like this.

Where does cancer come from? We must talk about preventable risk | Ranjana Srivastava

Although my patient constantly and laughingly referred to himself as a “vegetable”, I never got used to it. I cringed at the expression, often wondering how he really felt beneath the smiles. Short in height and morbidly obese, he hated moving and told everyone how much he loved fat and sugar, preferably together. The first time I met him he struggled to walk the few metres to my room before crashing into a chair and clutching its sides as he regained his breath. He was only 57 years old.

Just before starting chemotherapy he developed a urine infection. His symptoms settled quickly but even I was surprised at the way he became deconditioned. Previously able to get to the bathroom, now he would collapse in bed with each attempt to get up. Then he developed a hospital-acquired pneumonia and nearly died. It was assumed that cancer caused his deterioration, but the real culprit was his dismal lack of fitness. Ultimately, I witnessed my patient’s treatment, and then his life, compromised by habits encompassed by the benign-sounding term “lifestyle factors”. Unfortunately he was neither the first nor the last patient of this kind.

Recently, Australian researchers added to a growing body of evidence that a large proportion of cancers are preventable. The researchers studied known groups of cancer risk factors including smoking, diet, weight, physical inactivity and infections such as hepatitis C and human papillomavirus and estimated that of the 44,000 cancer deaths annually in Australia, 17,000, or nearly 40%, are potentially preventable. This figure mirrors those stated by Cancer Research UK, the American Cancer Society and the World Health Organisation.

Reflecting on the “untold grief and heartache” that cancer causes, the researchers remind us that even small improvements in our lifestyle have the capacity to translate into important health gains. On current trend, one in two people will be diagnosed with cancer by age 85. To reduce this risk, they suggest we make better dietary choices, eat a little less, move a little more, don’t smoke, curb drinking, and lose some weight. They’re right, of course. The frustration lies in seeing knowledge translated into action.

Every cancer clinic is witness to the end result of a series of lifestyle choices gone wrong. The middle-aged truck driver with lung cancer who has spent 20 years on the roads, with cigarettes, soft drinks and fast food for company. The obese, sedentary office worker suddenly diagnosed with advanced bowel cancer. The scores of men and women with obesity, emphysema, diabetes, heart and kidney disease, before facing cancer as a final insult. Everyone seems surprised that these chronic health conditions can imperil just as much as cancer.

Listening to patients provides insights into how their lifestyle came to be so. Some people can’t afford the cost premium of fresh fruit and vegetables and their living or working conditions make regular exercise difficult, if not impossible. Some people smoke because that’s what their whole family does. They drink because to refrain would be considered abnormal among their friends. Everyone in their family is on the large side, so they haven’t thought of themselves as overweight.

Smoking impairs response to cancer treatment. Obesity increases recurrence risk. Lack of fitness portends hazardous complications. Poor diet hampers immunity. There is common awareness of the link between smoking and cancer but few people are aware of the other major and controllable risk factors. Mostly, they think that cancer happens due to bad luck and bad genes.

Oncologists are no strangers to the plentiful associations between lifestyle and cancer but while I have no illusions about changing human nature in the course of a few appointments, it never fails to strike me how seldom we broach lifestyle. For one, it’s easier to prescribe chemotherapy than to counsel patients about their habits. In the short time available, it is expedient to stick to the necessary conversations which tend to be about diagnosis and management. It is increasingly challenging to adopt a long-term and holistic view of the person behind the cancer but this shortcoming undoubtedly hurts patients.

Giving chemotherapy is the easy part. Linking a patient into accessible, publicly funded, sustainable harm reduction programs, whether related to diet, exercise, smoking, drugs or alcohol is surprisingly difficult. There is enormous geographic and socioeconomic variation in access to such services – the employed executive with generous leave arrangements can find several options within easy reach but things aren’t so easy for the unemployed single mother who is also the carer for her disabled son. She is much more likely to retain all the factors that led to cancer development in the first place that will now claim her life.

One might ask if we shouldn’t take personal responsibility for getting healthy but recidivism rates are high because poor health habits are addictive and people need more structured help than simply being told to quit. The result of gaps in public health policy is a failure of primary prevention that leads to expensive hospital-based care, which is ill-equipped to change long-term health indicators.

When it comes to communicating risk, cancer occupies a unique and unfortunate space. Societies are aware about the dangers of unprotected sex. Mothers know why childhood vaccination matters. Public transport carries the warning features of a stroke. But the origin of cancer remains shrouded in mystery even as researchers peel back the layers.

It’s tricky at the best of times to tell someone to lose weight or drink less but it’s even harder to tell a patient that a cancer diagnosis might have been preventable if not for a host of lifestyle decisions. By sidestepping a conversation about risk factors we miss an important opportunity for educating the patient, concerned relatives and the broader community.

The conversation about cancer has always been framed as a battle. With its powerful imagery of productive lives laid to ruin cancer evokes fear, powerlessness and devastation like none else. It is widely perceived as a mysterious, insidious, and ultimately hopeless condition. For a disease where the patient never feels in charge, what the Australian researchers provide us is hope. Hope that knowing the risk factors is a step towards modifying them. Hope that like other diseases we have demystified, there are things we can do to prevent cancer.

While some of us have heard of someone who never smoked or drank, ran marathons and still got cancer, we all know someone who was obese or smoked or drank excessively who got cancer. Everyone deserves our sympathy and understanding but it would be even better if their experiences taught us something. A striking proportion of cancers are preventable. We ought to be grateful to the Australian researchers for showing us the way.

  • Ranjana Srivastava is an oncologist and a Guardian Australia columnist