Flinders University study shows bariatric surgery under threat as indemnity insurance costs rocket

There are fears more people could turn to risky new medications as a treatment for severe obesity comes under threat.

Bariatric surgery for severe obesity including gastric banding is under threat as rocketing indemnity insurance premiums and growing malpractice claims drive surgeons out of the field, experts warn.

The result could be more people turning to new weight loss medications, including GLP-1 “skinny jabs”, which come with multiple health risks.

Premiums soared 35 per cent last year to an average $70,000 with some surgeons reporting premiums as high as $500,000, a survey of 115 surgeons found.

A study by Flinders University, the University of Notre Dame Australia and the Australian and New Zealand Metabolic and Obesity Surgical Society warns bariatric surgery could soon become unsustainable to provide.

Professor Lilian Kow from Flinders University, a general surgeon and recipient of the Medal of the Order of Australia for services to bariatric and obesity medicine, says the situation is dire.

TV personality Andrew 'Cosi' Costello shed weight after bariatric surgery. Picture: File

Professor Lillian Kow from Flinders University. Picture: Brenton Edwards

“Obesity is one of the most urgent global health challenges of the 21st century,” she said.

“A third of Australian adults live with obesity, yet it’s still underdiagnosed, undertreated and too often misunderstood as a lifestyle issue rather than a complex disease.”

Despite its cost-effectiveness and role in preventing obesity-related conditions like type 2 diabetes and heart disease, bariatric surgery in Australia is almost entirely delivered through the private sector.

Surgeons must carry professional indemnity insurance to practice, but Prof Kow said the financial burden is forcing many to reconsider their future in bariatric surgery.

“Rural surgeons are hit even harder – facing steeper increases despite operating in regions where need is greatest,” she said.

“While new medications are poised to become an important part of obesity treatment, bariatric surgery continues to be the most effective and safest option.

“This is largely because these medications are expensive, not easily accessible, come with side effects and generally need to be taken indefinitely.”

Weight loss injections have been linked with risks including pancreatitis, gallbladder problems, vision problems and gastrointestinal issues.

More than 40 per cent of surveyed surgeons have faced at least one malpractice claim but just 2 per cent proceeded to trial — fuelling concerns Australia’s “no win, no fee” legal framework may be encouraging excessive or opportunistic litigation.

“Surgeons are being penalised by rising premiums often driven by broader trends, not their own clinical records,” Prof Kow said.

“We risk losing highly skilled professionals, particularly in rural areas where obesity is more prevalent and specialist care is already scarce.”

Notre Dame researcher and bariatric surgeon Associate Professor Nick Williams said: “Obesity disproportionately affects lower socio-economic groups, regional and remote communities and Indigenous populations.

“These are patients with the greatest need for access to obesity care, and if surgeries are not available publicly then we at least need them to be available as cost effectively and as widely as possible in the private sector.”