title: Characteristics of the population eligible for and receiving publicly funded bariatric surgery in Canada.
abstract: BACKGROUND
  Bariatric surgery is the most effective current treatment for severe obesity. Capacity to perform surgery within Canada's public health system is limited and potential candidates face protracted wait times. A better understanding of the gaps between demand for surgery and the capacity to provide it is required. The purpose of this study was to quantify and characterize the bariatric surgery-eligible population in Canada in comparison to surgery-ineligible subjects and surgical recipients.
  
  
  METHODS
  Data from adult (age > 20) respondents of the 2007-09 nationally representative Canadian Health Measures Survey (CHMS) were analyzed to estimate the prevalence and characteristics of the surgery-eligible and ineligible populations. Federally mandated administrative healthcare data (2007-08) were used to characterize surgical recipients.
  
  
  RESULTS
  In 2007-09, an estimated 1.5 million obese Canadian adults met eligibility criteria for bariatric surgery. 19.2 million were surgery-ineligible (3.4 million obese and 15.8 million non-obese). Surgery-eligible Canadians had a mean BMI of 40.1 kg/m2 (95% CI 39.3 to 40.9 kg/m2) and, compared to the surgery-ineligible obese population, were more likely to be female (62 vs. 44%), 40-59 years old (55 vs. 48%), less educated (43 vs. 35%), in the lowest socioeconomic tertile (41 vs. 34%), and inactive (73 vs. 59%). Self-rated mental health and quality of life were lower and comorbidity was higher in surgery-eligible respondents compared with the ineligible populations. The annual proportion of Canadians eligible for surgery that actually underwent a publicly funded bariatric surgery between 2007-09 was 0.1%. Surgical recipients (n = 847) had a mean age of 43.6 years (SD 11.1) and 82% were female. With the exception of type 2 diabetes, obesity-related comorbidity prevalence was much lower in surgical recipients compared to those eligible for surgery.
  
  
  CONCLUSIONS
  The proportion of bariatric surgery-eligible Canadians that undergo publicly funded bariatric surgery is very low. There are notable differences in sociodemographic profiles and prevalence of comorbidities between surgery-eligible subjects and surgical recipients.
authors.affiliation: Department of Medicine, 2F1,26 Walter C, Mackenzie Health Sciences Centre, University of Alberta, 8440-112th Street, Edmonton, T6G 2B7, Alberta, Canada. rpadwal@ualberta.ca
authors.forename: Raj S
authors.initials: RS
authors.lastname: Padwal
authors.forename: Hsui-Ju
authors.initials: HJ
authors.lastname: Chang
authors.forename: Scott
authors.initials: S
authors.lastname: Klarenbach
authors.forename: Arya M
authors.initials: AM
authors.lastname: Sharma
authors.forename: Sumit R
authors.initials: SR
authors.lastname: Majumdar
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000191:economics / Q000706:statistics & numerical data*; D002170:Canada / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008483:Medical Assistance / Q000706:statistics & numerical data; D008875:Middle Aged; D009765:Obesity / Q000191:economics / Q000453:epidemiology / Q000601:surgery; D015995:Prevalence; D055815:Young Adult