A booming trade in medical tourism for weight loss surgery is placing patients at risk and needs urgent regulation, experts have warned.
Despite the growing popularity of injections such as Mounjaro to treat obesity, the number of patients travelling to other countries for surgery is increasing, the latest analysis suggests.
And, with the wider medical tourism industry set to be worth about £300bn annually, with anticipated year-on-year growth of 25%, international regulation is urgently needed, according to a commentary in the journal BMJ Global Health.
“We are seeing this ongoing increase, linked to the globalisation of healthcare and long wait lists,” said Dr Jessica McGirr of the University of Medicine and Health Sciences in Dublin and Imperial College London, adding that many are being marketed bariatric surgery through “before and after” images on TikTok and Instagram.
“Incorrectly, surgery is often marketed from an aesthetic point of view,” McGirr said. “This is complex surgery for treatment of a chronic disease with potentially significant health complications.”
Lengthy NHS waiting lists, typically two years or more from referral, the unaffordable cost of private surgery in the UK and the increasing number of people living with obesity have led to more patients seeking bariatric surgery abroad.
The out-of-pocket cost for bariatric surgery done privately in the UK is about £10,000-£15,000, but £2,500-£4,500 in countries such as Turkey, the commentary estimates. However, medical tourism packages rarely cover continued care in the case of complications or long-term nutritional or psychological support.
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“If you just look at the statistics, there are nearly 4 million people in the UK who meet the Nice criteria for surgery, but we only do around 5,000 cases each year,” said Ahmed Ahmed, a consultant bariatric surgeon at Imperial College healthcare NHS trust and the president of the British Obesity & Metabolic Specialist Society. “I certainly don’t blame the patients. They recognise they have a disease.”
“I don’t even blame the surgeons abroad,” Ahmed added. “They see a gap in the market and they’re exploiting it. They’re able to supply surgery at a much cheaper price. What I don’t like is when we see patients with problems from poorly conducted surgery. That upsets me a lot.”
The BMJ commentary calls for the urgent creation of international quality standards for weight loss surgery, including an accreditation process that patients can use to choose high-quality providers abroad. This, McGirr suggested, could be funded by providers. “There will be resistance to regulating the industry,” she said. “Undoubtedly, not all centres would seek accreditation or regulation.”
Procedures include gastric sleeve surgery, in which the size of the stomach is decreased by more than 70%, and gastric band surgery, which narrows the intestine. Both aim to restrict eating by making a person feel full, leading to a reduction in appetite.
Botched surgery can lead to infections, surgical leaks, internal hernias and, in the worst cases, be fatal. Foreign Office figures from March 2024 revealed that at least 28 British people had died since 2019 due to complications from elective medical procedures performed in Turkey, many of which are thought to have been bariatric surgery. Last month, a doctor told the inquest of a 40-year-old British woman who died following weight loss surgery in Turkey in 2024 that he had dealt with more than 100 other patients suffering complications after undergoing similar procedures abroad.
However, Ahmed said he had observed a decrease in patients attending A&E with acute complications in the last two years, which he puts down to people choosing to privately fund obesity drug treatments rather than surgery.