Unfortunately this is done on the NHS, which means he gets paid shit, and the taxpayers are covering it. He's just marketing it so he can keep his job. The whole system is totally mismanaged and massively under financed at the same time, and oh look, who should we cut out of it? The morbidly obese or the disabled? Hmmm....  The whole show was pretty much just shameless marketing. It peaks a few seasons later when he explains that if a fat person just keeps the weight off for 5 years, the surgery has already paid for itself in savings on them. Sadly that's probably true.