A properly resourced obesity treatment programme is needed in Ireland, as waiting lists continue to grow.
That's according to Helen Heneghan, professor of surgery at St Vincent's University Hospital in Dublin and a consultant bariatric surgeon.
She told Newstalk Breakfast surgery is the most effective treatment for severe obesity.
"Demand, I suppose, is as high as the prevalence of obesity is in Ireland... one in four adults, one in five children.
"So the prevalence of obesity runs into the hundreds of thousands, if not well over a million people affected by the disease.
"Obviously not everybody has the same severity of disease - but about 80% of people with obesity will have a complication that affects their health in some way.
"Those people would be eligible for obesity treatments - and they take many forms from supervised lifestyle changes, to obesity medications.
"And certainly bariatric surgery, then, is the most effective treatment for severe obesity".
'So difficult to access'
Prof Heneghan says hundreds of thousands of people currently meet eligibility requirements for the surgery.
"But a lot of people don't even know that it exists as an effective and safe treatment, and how to access it".
She says just two centres in Ireland provide bariatric surgery to the public, which is leading to long waiting lists.
"They're too long, because it's so difficult to access it, particularly in the public sector in Ireland.
"There's only two centres in Ireland that provide bariatric surgery to the public: ours in Loughlinstown and St Vincent's University Hospital and there's a service in Galway, which actually isn't even resourced properly to deliver all of the elements of the multi-disciplinary care that patients require."
She says they are performing around 80 to 100 surgeries a year, which is nowhere near demand.
"There's over 2,600 patients waiting to get into our clinic at the moment.
"So the wait to get a first appointment is over four years".
She says a properly resourced obesity treatment programme is needed.
"There's a model of care in place led by Donal O'Shea, published, that outlines exactly how we need to do this.
"The component relative to bariatric surgery... informs the Department of Health that we should be doing 1,200 cases of these a year.
"That still wouldn't bring us in line with the country in Europe that does the next lowest numbers of surgeries, which would be the UK.
"There's a plan to resource it fully, but it hasn't gotten over the line in the last few weeks and months".
She says a stigma attached to weight gain could prevent people from coming forward.
"Weight stigma is prevalent throughout many aspects of society - many patients have an internal stigma where they won't even seek treatment for weight and for obesity.
"They feel, in some respects, they're shamed; they've been taught and told that it's their fault for many many years.
"And yet there's a wealth of science that tells us that that isn't the case, that it isn't people's fault.
"That obesity is a disease, a very treatable disease admittedly, but that we can't control our weight just like we don't control our body temperature, we don't control our hemoglobin, our blood count [and] other things - it's involuntary".