More and more Russians are treating obesity with the help of a surgeon

Russian doctors are increasingly forced to prescribe special bariatric surgeries for overweight patients. According to the All-Russian Bariatric Registry, in 2020, 3292 surgical interventions in the stomach and intestines were performed, and in 2023 there were already 8955 – 172% more. Doctors interviewed by Kommersant confirm that in recent years, specialists in bariatric surgery have appeared in almost all major cities of Russia, but there are still not enough of them.

“Kommersant” studied the latest statistical data from the All-Russian Bariatric Registry. “Bariatrics is a branch of surgery that deals with the treatment of obesity,” explained Maxim Burikov, head of the Center for Bariatric Medicine of the FMBA in Rostov-on-Don, creator of the Slimmer app for obese people. “This is not about aesthetic intervention, but about the fight against weight, health threatening. In people with body mass index (BMI, the ratio of a person’s weight to his height.— “Kommersant”) Above 40, profound changes in metabolism and hormonal disturbances occur. Because of this, losing weight and keeping it off naturally becomes difficult and sometimes impossible. As a result of the operation, patients lose 20–35% of their total body weight, which is about 60–70% of excess weight.”

The All-Russian Bariatric Registry has been maintained since 2013. Between 2013 and 2019 inclusive, 13,688 bariatric surgeries were performed in Russia. In 2020, 3292 such surgical interventions were performed, in 2021 there were already 5833, in 2022 there were 8129, and last year 2023 – as many as 8955. Thus, since 2020, the number of bariatric operations in Russia has increased by 172%. However, the United States is still far from being the world leader: according to the Global Report on Bariatric Surgery for 2023, 209,527 interventions were performed there. Next come Brazil (70,490) and France (38,890).

According to the registry, in Russia the most popular such operation in 2021 (more recent data could not be found) was longitudinal resection of the stomach, that is, removal of part of it. In second place is gastric bypass surgery (reduction of the stomach and small intestine), in third place is the SADI method (a modification of bypass surgery in which the small intestine is excluded from the digestive process).

At the request of Kommersant, Maxim Burikov analyzed information about 2052 patients who turned to him for help from October 2021 to October 2023. It turned out that 87% of them were women. The largest age groups were 31 to 40 years (746 patients) and 41 to 50 years (582). Moreover, 32% of patients at the time of surgery had a BMI of 40 or more; According to WHO, this is obesity of the third and fourth (last) degrees.

According to the All-Russian Bariatric Registry, only 30% of patients do not have any other pathologies. Every fourth person has three to five obesity-related diseases. And among patients with super obesity (BMI over 55), every second person has five or more diseases. As of the first quarter of 2023, the registry included information about 3,596 patients with hyperobesity (9.8% of all patients in the registry). The proportion of men in this category is 35%, which is noticeably higher than the average among bariatric patients.

Maxim Burikov points out that when prescribing an operation, the patient’s body mass index is first taken into account – both current and maximum in the history of observations. If it is above 40, then surgical intervention is permissible, even if the patient does not have diseases associated with obesity. Chairman of the National Association of Healthcare Managers, surgeon Muslim Muslimov adds: bariatric surgery is also recognized as effective in treating type 2 diabetes. “Unfortunately, in our country there is an exponential increase in patients suffering from this disease, so this type of treatment is becoming increasingly in demand,” says Mr. Muslimov. “Currently, we can state the emergence of a trend for cooperation between endocrinologists and surgeons. Endocrinologists began to refer patients for bariatric treatment, which was not the case before.”

It is these two categories of patients – those with a BMI equal to or above 40, and those with obesity combined with type 2 diabetes – who can receive a quota for high-tech medical care. According to Muslim Muslimov, “through endocrinologists” about 600 quotas per year are allocated for patients suffering from type 2 diabetes with complications. For the rest, Maxim Burikov points out, the operation costs from 200 thousand to 400 thousand rubles.

Muslim Muslimov notes another trend: an increase in the number of surgeons and centers specializing in bariatric surgery. According to him, five to seven years ago in Russia there were no more than ten such specialists, but now there are already several dozen. Bariatric surgery is represented in almost all major cities of the Russian Federation, Mr. Muslimov points out. Nevertheless, the country still lacks specialists in bariatric surgery, says Mr. Burikov: “This problem is especially familiar to regional medical institutions. Due to the fact that there are no surgeons with the required specialization in the regions, patients have to travel distances for interventions and long-term observation. This may be one of the reasons for refusing surgery.”

“Kommersant” sent a request to the Ministry of Health with a request to comment on the reasons for the increase in the use of bariatric surgeries, but at the time of publication did not receive a response. According to the Rosstat collection “Healthcare in Russia-2023”, at the end of 2022, more than 419 thousand new cases of obesity were identified in the country (in 2021 – more than 383 thousand, in 2020 – almost 372 thousand). In August 2023, Health Minister Mikhail Murashko reported that overweight was becoming “quite widespread,” including among children. According to his presentation, over the past five years the proportion of Russians who are obese has rapidly increased by 30% – and now every tenth person in the country is overweight.

Natalia Kostarnova