Bariatric Surgery - Indications

Indications

A medical guideline by the American College of Physicians concluded:

  • "Surgery should be considered as a treatment option for patients with a BMI of 40 kg/m2 or greater who instituted but failed an adequate exercise and diet program (with or without adjunctive drug therapy) and who present with obesity-related comorbid conditions, such as hypertension, impaired glucose tolerance, diabetes mellitus, hyperlipidemia, and obstructive sleep apnea. A doctor–patient discussion of surgical options should include the long-term side effects, such as possible need for reoperation, gallbladder disease, and malabsorption."
  • "Patients should be referred to high-volume centers with surgeons experienced in bariatric surgery."

Recently the International Diabetes Federation issued a position statement in which "Under some circumstances people with a BMI 30–35 should be eligible for surgery" International Diabetes Federation position statement on Bariatric Surgical and Procedural Interventions in the Treatment of Obese Patients with Type 2 Diabetes When determining eligibility for bariatric surgery for extremely obese patients, psychiatric screening is critical; it is also critical for determining postoperative success. In patients with a body mass index of 40 kg/m2 or greater, there is a 5-fold risk of depression, and half of bariatric surgery candidates are depressed.

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