More than two million adults in England could be eligible for weight loss surgery, according to research.
Some 8,000 people receive bariatric surgery each year, but researchers from Imperial College London say more than 5% of adults would qualify, more than 2.1 million people.
Operations for weight loss such as the fitting of a gastric band or gastric bypass surgery, is currently available on the NHS to treat those with potentially life-threatening obesity.
The study, published in the Journal of the Royal Society of Medicine, found that despite evidence of the cost-effectiveness of weight loss surgery, surgery rates were estimated to be a third of the NHS's benchmark rate.
The number of people eligible for surgery "far exceeds" the estimated number of people having procedures.
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She told reporters: "I don't think it's fully sunk in how really bad that could have been, I know it's not the right decision."