SurgiCal Obesity Treatment Study (SCOTS)

Every year, thousands of people in the UK undergo bariatric surgery to treat severe obesity, but doctors lack clear evidence on which patients benefit most and what long-term complications to expect. This study will recruit 2,000 patients in Scotland and follow them for an average of 10 years, tracking weight, diabetes, heart disease, cancer, fractures, nutritional deficiencies, mental health, and surgical complications. The core problem is that existing evidence on bariatric surgery outcomes is inconsistent, leaving clinicians unable to reliably predict who will have the best improvements or the highest risk of revisional surgery and long-term harm. If this research succeeds, it will give surgeons and GPs concrete data to guide patient selection, pre-surgery counselling, and post-operative monitoring. The findings could directly change how the NHS manages severe obesity—shifting from a one-size-fits-all surgical approach to one tailored by patient characteristics. For the 2,000 participants and the thousands who will follow, this could mean fewer failed surgeries, better-targeted follow-up care, and clearer conversations about realistic outcomes. The study does not test a new treatment; it provides the long-term evidence base that current practice lacks.