For the first time in more than thirty years, two of the leading organizations for bariatric surgeons and integrated health professionals have released new weight-loss surgery guidelines. Updated evidence-based recommendations from the Ìýand the Ìýwiden patient eligibility for weight-loss surgery and advocate for metabolic surgery for patients with type 2 diabetes and a body mass index (BMI) of 30 or above.
“For the first time in more than 30 years, we – as a medical society – have released healthcare guidelines that highlight how the detrimental effect of obesity cannot be confined by outdated numbers," said Dr. Konstantinos Spaniolas, Chief of the of Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery and Director of Stony Brook's award-winning . "New guidelines, based on decades-long scientific evidence, suggest that bariatric surgery should be considered for patients with a Body Mass Index of 35 and over, regardless of the presence of obesity-related conditions. Importantly, these same guidelines, suggest that for patients with metabolic diseases – diabetes, hypertension or dyslipidemia – surgery can have a profound benefit and should also be discussed," he continued.
In 1991, when the previous guidelines were released, bariatric weight-loss surgery was only recommended for patients with BMIs of at least 40 or with BMIs 35 and above with at least one co-morbidity such as heart disease or hypertension. Bariatric surgery was also not recommended for children or adolescents at the time. And the most common surgical procedures were the vertical banded gastroplasty (VBG), which "has fallen out of favor" (according to an article from the ), and Roux-en-Y gastric bypass (RYGB).
These updated guidelines from the ASMBS and IFSO come after decades of long-term studies of safety and effectiveness, the development of new surgical procedures (such as sleeve gastrectomy and RYGB), including the common use of laparoscopic techniques and robotic-assisted (these minimally invasive procedures are now preferred for metabolic and bariatric surgery (MBS), and evidence-based proof that MBS leads to better weight-loss results than non-surgical treatments, while decreasing overall mortality and improving overall health. According to the report, "Perioperative mortality is very low, ranging between .03% and .2%." It further states that "MBS has become one of the most commonly performed operations in general surgery."
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The new guidelines recommend MBS for people with:
- BMI=35 kg/m2, regardless of presence, absence, or severity of co-morbidities
- Type 2 diabetes and BMI =30 kg/m2
- BMI of 30–34.9 kg/m2 who haven't demonstrated considerable or enduring weight loss or improvement of co-morbidity with nonsurgical methods
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The recommendations also suggest that older patients (after careful appraisal of their overall health and co-morbidities), children/adolescents (after a detailed evaluation) and select high-risk patients could also benefit from MBS. And, finally, the guidelines also note that the BMI ranges do not apply to all populations in the same way (for instance, the Asian population has a higher prevalence of diabetes and cardiovascular disease at lower BMIs), therefore, BMI should not be the sole factor in determining an MBS recommendation.
If you'd like to learn more about bariatric and metabolic weight loss options, please visit . There you can meet our team of nationally recognized surgeons, schedule a consultation and access a wide variety of resources (including a handy ). You can also click here to download a PDF brochure with information about ÐÇ¿ÕÎÞÏÞ´«Ã½'s Bariatric and Metabolic Weight Loss Center.