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| ORIGINAL ARTICLE |
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| Year : 2017 | Volume
: 5
| Issue : 1 | Page : 15-21 |
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A needs assessment of bariatric surgery services in Saudi Arabia
Naif Al-Enazi, Haitham Al-Falah
Prince Mohammed bin Abdul-Aziz Hospital, Riyadh, Saudi Arabia
| Date of Web Publication | 13-Jul-2017 |
Correspondence Address:
Naif Al-Enazi
Prince Mohammed bin Abdul-Aziz Hospital, Al-Imam Ahmad Bin Hanbal St, Ar Rawabi, Riyadh 14214
Saudi Arabia
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/sjo.sjo_23_16
Background: Obesity in Saudi Arabia is a serious problem; 30% of men and 44% of women are obese, and these levels are anticipated to rise. Fortunately, obesity is amenable to surgical intervention. However, we do not know if Saudi Arabia has enough bariatric surgery services. The literature has already determined the number of bariatric surgeons and the number of bariatric surgeries annually in Saudi Arabia but has not investigated whether these services are sufficient for the size of the Saudi population.
Objective: The objective of this study was to determine if Saudi Arabia needs more bariatric services.
Materials and Methods: The research was conducted by an email survey of 31 bariatric surgeons in Saudi Arabia. Likert scale based questionnaire was used to obtain opinions about the need for more bariatric surgeons.
Results: This study found that Saudi Arabia does need more bariatric surgery services. Totally, 55% of the respondents agreed that Saudi Arabia needs more bariatric surgery services, 65% agreed that Saudi Arabia’s need for such services will increase in the next 10 years, 54% mentioned they had a long waiting list for bariatric surgery.
Conclusion: The results of this study showed that Saudi Arabia needs more bariatric surgery services. Therefore, hospitals in Saudi Arabia and the government should invest more in bariatric services. Keywords: Bariatric services, bariatric surgery, obesity, saudi arabia
How to cite this article:
Al-Enazi N, Al-Falah H. A needs assessment of bariatric surgery services in Saudi Arabia. Saudi J Obesity 2017;5:15-21 |
| Introduction | |  |
The Kingdom of Saudi Arabia has a serious obesity problem.[1],[2] This is shown by the fact that Saudi Arabia has the 11th highest adult obesity rate out of 188 countries.[3] Furthermore, 30% of men and 44% of women are obese.[3] Researchers believe that the obesity problem will only get worse; by 2022, these figures will have risen to 41 and 78%, respectively.[4] Given the seriousness of the obesity problem in Saudi Arabia, the country needs solutions.[5],[6],[7] Studies have found that bariatric surgery is the most effective treatment for obesity.[8],[9] In one study, for example, patients lost 26 kg more weight with bariatric surgery than nonsurgical treatments.[10] Furthermore, the patients who underwent bariatric surgery had a higher remission rate of obesity complications than the patients who were only dieting and exercising. A further advantage of bariatric surgery is that it is cost-effective compared to nonsurgical methods.[11],[12] Given the advantages of bariatric surgery, we should, therefore, expect Saudi Arabia to have a large number of bariatric surgery services to treat its millions of obese citizens. However, information is lacking as to whether Saudi Arabia does have enough bariatric surgery services. One study found that Saudi Arabia only had 48 bariatric surgeons in 2012, which is low compared to other countries.[11] The objective of this study to determine if Saudi Arabia needs more bariatric surgery services.
| Materials and methods | | |
This survey was conducted in march 2016 among bariatric surgeons in Saudi Arabia. The questionnaire was constructed based on relevant studies.[13],[14]
The questionnaire consisted of relevant questions about age, gender, nationality, profession, numbers and types of bariatric annual operations, attitude towards performing obesity related operation and the need for obesity related surgery services in Saudi Arabia (Appendix 1 [Additional file 1]). Questionnaire was distributed by e-mail to all bariatric surgeons who agreed to participate in this study in Saudi Arabia. Microsoft Excel was used for data entry and analysis.
| Results | | |
The questionnaire was distributed to 43 bariatric surgeons, 31(72%) out of them completed it and returned it back to the investigator. Findings of this study are illustrated in [Table 1],[Table 2],[Table 3],[Table 4]. | Table 2: Number and type of bariatric surgeries performed by the respondents annually
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 | Table 3: Confidence of participants regarding performing different types of bariatric surgeries (N=31)
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 | Table 4: Opinions of participants regarding need for bariatric surgery services in KSA (N=31)
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[Table 1] shows some demographic characters of participants. Majority of them were males, above 40 year old , and Saudi. More than half of participants are primarily bariatric surgeons. [Table 2] depicts the types of bariatric surgeries performed by participants annually. The most common type was sleeve gastrectomy followed by Roux-en-Y gastric bypass and then gastric banding.
The survey asked the respondents how confident they felt performing the various types of bariatric surgery [Table 3]. The respondents felt most confident regarding performing Roux-en-Y gastric bypasses (66%), followed by gastric banding (62%) and sleeve gastrectomies (58%). The respondents felt the least confident performing biliopancreatic diversions (71%) and duodenal switch (also 71%). Regarding multidisciplinary resources, only 36% of the respondents agreed that they had multidisciplinary resources at their workplace; 17% disagreed with this statement.
Regarding the need for bariatric surgery services [Table 4], the most important statement was, “Saudi Arabia needs more bariatric surgery services.” The responses for this statement were as follows: strongly disagree: 24%; disagree: 7%; normal: 14%; agree: 31%; strongly agree: 24%. Therefore, most respondents (55%) agreed or strongly agreed with the statement, which means the consensus is that the country needs more bariatric services. For the statement “Saudi Arabia needs more bariatric surgeons,” 31% of the respondents disagreed and strongly disagreed, and 45% agreed and strongly agreed, so again the consensus leans toward a need for more bariatric surgeons. The survey also provided the opposite statement: “There are too many bariatric surgeons in Saudi Arabia.” The large majority of the respondents (84%) disagreed with this statement. This implies that most respondents believed there are too few surgeons in Saudi Arabia. The responses to the other statements also support the idea that Saudi Arabia needs more bariatric surgeons. For example, 65% believed that Saudi Arabia’s need for bariatric surgery will increase in the next 10 years; 54% said they personally had a long waiting list for bariatric surgery; 52% said the waiting lists for bariatric surgery in general are long; and 45% said they felt overworked.
| Discussion | | |
The opinions of the respondents showed that Saudi Arabia needs more bariatric surgery services. Most respondents believed that (1) there is a long waiting list for bariatric surgery, (2) demand for bariatric surgery will increase soon, and (3) the country needs more bariatric surgery services.
The findings of a study by Buchwald and Oien[11] also implied that Saudi Arabia needs more bariatric surgery services. Their study found that Saudi Arabia only had 48 bariatric surgeons in 2012, which was low compared to other countries.[11] Furthermore, Buchwald and Oien[11] found that each bariatric surgeon in Saudi Arabia performed an average of 146 surgeries a year, which was the third highest among the 42 countries involved in their study. On average, bariatric surgeon performs 341 operations annually which higher than that reported earlier.[11] This figure indicates that bariatric surgeons in Saudi Arabia were overworked which emphasize the need for bariatric surgeons to cover such shortage.
The survey also asked about the respondents’ confidence at performing the various types of bariatric surgery. The respondents felt most confident when performing gastric bandings, sleeve gastrectomies, and Roux-en-Y gastric bypasses. This finding correlates with the results of a study in 2013, which found that the adjustable gastric band, sleeve gastrectomy, and Roux-en-Y gastric bypass are the most performed procedures in Saudi Arabia.[11]
In conclusion, this study revealed that despite the high magnitude of obese patients who need urgent surgical intervention, there is shortage in the number of bariatric surgeons who were overworked. High authorities in health sectors over KSA should think wisely how to fill such gap between severe shortage and high needs.
Acknowledgements
The authors acknowledge the support and supervision of John L. Falcone, M.D., M.Sc. at Owensboro Health Department of Surgery and his invaluable advice regarding research article writing.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4]
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