Recent reports made crude calculations for the cost of RIO, by dividing the cumulative weight loss by the number of patients referred. 

To accurately assess the cost-effectiveness of RIO we need to look at those patients who have completed their 6m weight loss programme.  Furthermore, this calculation should not include children, when in the majority of cases (for good clinical reasons) we aim for weight maintenance rather than loss. 

In addition we should take into account the huge financial savings that have already been demonstrated from this specialist approach to weight management.  The anticipated number of adults expected to need costly bariatric surgery for weight loss during the 2010/11 year was 67, but thanks to many of these patients being successfully managed by the RIO multi disciplinary team approach, this number was slashed to just 33.  The cost of savings to the NHS just from having reduced the number of patients needing expensive and invasive surgery by 34 far exceeds the overall annual cost of the adult specialist obesity service.  We have also reduced the number of inappropriate referrals from approximately 50% to none at all, thereby making further savings to the NHS through less wasted time for the surgical teams.   

Although harder to quantify, further savings can be demonstrated in the management of morbidly obese children, who may otherwise require a referral to a residential weight management camp, or future surgery.   

Two thirds of the UK population are currently overweight or obese and there is overwhelming evidence that weight loss, or even weight maintenance in patients who were otherwise increasing in weight has significant health benefits to the individual, together with long-term savings to the NHS as a consequence of having to treat less associated medical problems, such as type 2 diabetes and cardiovascular disease.  Morbidity and mortality are directly linked to weight, so any weight loss in an overweight or obese individual is beneficial.