Experts demand crackdown on rogue medical practices abroad

Obesity experts have called for a crackdown on dodgy practices at clinics facilitating medical tourism to prevent further “heartbreaking” tragedies.

Thousands of people are thought to travel from the UK for cut-price bariatric surgery in countries such as Turkey every year.

But leading medics say procedures are too often botched, causing infections, permanent injuries and fatalities.

Three leading European organisations brought together 119 experts and 88 patient representatives who agreed on 126 recommendations to improve care and end unethical practices.

They warned against use special offers such as two-for-one deals and said patients should not be offered bariatric surgery unless they are obese, with a BMI over 30kg/m2.

Project leader Dr Laurence Dobbie, an expert in general practice and obesity medicine at King’s College London, told the Express medical tourism was “a big problem” for the UK.

He said: “I’ve previously worked in bariatric centres and there are quite a lot of patients that go abroad, mostly to Turkey, for weight loss surgery.

“Some of these patients, it’s driven by long waiting lists which can stretch to many years. Some people that aren’t eligible for it in the UK go abroad.

“Because this is completely unregulated, we don’t have a grasp of the true scale of this, but patients are coming to harm.”

Tragic cases include the death of Shannon Bowe, who travelled from Scotland to Turkey for gastric sleeve surgery in 2023.

The 28-year-old died after suffering catastrophic blood loss during the procedure and her family have since called for UK hotel chains to stop running marketing events for overseas clinics.

Dr Dobbie and his colleagues agreed that bariatric surgery should only be performed at centres accredited by either the European Association for the Study of Obesity (EASO) or each country’s national representative bariatric or surgical society.

They said all patients travelling for treatment should spend at least five days in the country after their operation before returning home, and they should be followed up by their clinic for at least two years.

Surgeons should also liaise with the patient’s GP or doctor at home to facilitate ongoing care, the group suggested.

Dr Dobbie said bariatric surgery was “a really safe and effective procedure, and it’s life-changing for a patient” when done correctly, but too many overseas clinics do not take enough care to ensure safety.

“You shouldn’t be able to get a two-for-one offer or discount deals on having weight loss surgery,” Dr Dobbie added. “You need to make lifelong changes to your dietary habits for this.

“With someone who has not tried a lifestyle change first, it is concerning if they’re just going straight for the most significant intervention we have.”

The expert group included members of EASO, the International Federation for Surgery of Obesity and Metabolic Disorders European Chapter, and the European Coalition for People Living with Obesity.

The recommendations are only guidelines but Dr Dobbie said it was necessary to try to encourage change at clinic-level because enforcing mandatory regulations internationally would be difficult.

Professor Volkan Yumuk, EASO president and based at Istanbul University-Cerrahpaşa in Turkey, said: “There have been too many cases of poorly performed, and in some cases, unsafe obesity surgery carried out abroad under what we would call medical tourism.

“In producing these guidelines, the obesity community has come together to make sure obesity surgery in Europe is safe and meets appropriate standards, wherever it takes place.” 

The consensus paper was published in the International Journal of Surgery.