Leading UK doctors are warning that the National Health Service is being left to “pick up the pieces” from complications linked to a rise in surgical tourism.
There are also fears that people of normal weight are buying slimming drugs, such as Ozempic and Wegovy, online without proper “wraparound” care.
A rising number of people are travelling abroad for procedures including weight-loss surgery and hair implants, but may not be getting the same standard of care that they would expect in the UK, said Prof David Strain, a professor of cardiometabolic health.
Prof Strain, chairman of the British Medical Association’s board of science, said medics in the UK are seeing an increasing number of patients with complications, including infections, from operations.
Foreign Office travel advice says that the standard of medical centres and available treatments can “vary widely globally”, and tells of six British nationals who died in Turkey in 2023 after medical procedures.
Medics at the the BMA’s national annual meeting in Belfast heard that there has been a “boom” in surgical tourism, which is “leading to a rise in serious post-surgery complications and deaths”.
Delegates passed a motion expressing concern about patients who need emergency surgery when they return to the UK.
The motion also called for an increase in weight-management services “partially” funded by a rise in the sugar tax.
Lose weight the healthy way - in pictures
“Several overseas clinics provide bariatric surgery far cheaper than the cost of disposable instruments used in the NHS. Follow-up is typically non-existent," said Dr Samuel Parker from the BMA, presenting the motion.
“[There are] reports of shortcuts, inappropriate use of disposable instruments and patients suffering serious complications necessitating emergency NHS treatment.”
On the sugar tax, Dr Parker said: “The sugary drinks tax in England was followed by a drop in a number of cases of obesity among older primary school children.
"It is estimated that 5,000 cases of obesity per year may be prevented in Year 6 girls alone.”
Prof Strain told journalists: “Surgical tourism has been a problem for some time.
"People disappear off to notably South Africa and Turkey, but there’s many other places to disappear to.
“And complications can arise late from any procedure, not just obesity surgery, even just something as simple as hair implants that people travel for.
“You can get infections and the problem is people come back and they are asking the NHS to pick up the pieces of procedures that were done with less standards that we would normally apply in the UK.
“Health tourism is on the rise as people are slightly more affluent. International travel is easier than it was. Organising these things are easier thanks to the internet.”
He said that the increase in anaesthetic procedures abroad have been spurred on by a “social media nation” where people feel the need to present themselves in a certain way.
“What we can never guarantee is the surgical standards in different countries, and even the equipment that may be used, and that’s where the risk comes,” Prof Strain said.
He said that someone who has returned from abroad and needs urgent treatment after a botched operation is taking a bed that could be used for an elective procedure, adding to delays.
“In an already overburdened health service then, health tourism can cause significant issues,” Prof Strain said.
On weight-loss drugs, he said: “One of the big worries about using these agents without a full wraparound service is that if you just give a drug that makes people lose weight, without the proper wrapround care that goes with it – talks about the changes in diet required and exercise that is absolutely required.
"Then people will lose fat and muscle and other tissues, and we end up with a condition called sarcopenic obesity, where basically the muscles are being lost at the same rate that the fat is being lost, and you see that so-called Wegovy face, which is very gaunt.
“In all of the trials for weight-loss drugs, every single one of them, it was drug-plus-lifestyle intervention and dietary advice.
"And the worry is that if you just buy these drugs off the internet without that … support, you end up jabbing yourself, and we don’t know the health benefits will be the same in those settings.”
Prof Strain said one of the problems with weight-loss pills was that tests had not been conducted on people of normal weight, so the effects were unknown.
“There’s always concerns about online drugs that have side-effects, that have interactions, and that can have an undesired effect if given to the wrong person.
“And any drug if it’s given to the wrong person can potentially do harm.
“Once you are living with obesity the brain chemistry changes, and these drugs are all about correcting the brain chemistry, so you start to feel satiated from food, you start to eat normal amounts.
“If you are a completely normal weight and you don’t have these alterations in brain chemistry, it’s entirely possible the drugs do absolutely nothing.
"Or it’s entirely possible that they even muck up the brain chemistry.
“They’ve never been tested in those populations. These are drugs that have been tested and they have got amazing results in people living with obesity, have amazing results from people with diabetes – we’re starting to see results in kidney disease and other disease states.
“But throughout the trials, nobody has been using these drugs in people who have normal weight without diabetes, because it made no sense.
“So if you’re asking me what the effects are, I don’t know.”
