Elsevier

Surgery for Obesity and Related Diseases

Volume 9, Issue 1, January–February 2013, Pages e1-e10
Surgery for Obesity and Related Diseases

ASMBS statements/guidelines
Bariatric surgery in class I obesity (body mass index 30–35 kg/m2)

https://doi.org/10.1016/j.soard.2012.09.002Get rights and content

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Preamble

The following position statement is issued by the American Society for Metabolic and Bariatric Surgery in response to numerous inquires made to the society by patients, physicians, society members, hospitals, and others regarding the safety profile and efficacy of bariatric surgery for patients with class I obesity. In this statement, available data are summarized, and recommendations for treatment are made regarding bariatric surgery for patients with a body mass index (BMI) of 30–35 kg/m2

Summary and recommendations

  • 1.

    Class I obesity is a well-defined disease that causes or exacerbates multiple other diseases, decreases the duration of life, and decreases the quality of life. The patient with class I obesity should be recognized as deserving treatment for this disease.

  • 2.

    Current options of nonsurgical treatment for class I obesity are not generally effective in achieving a substantial and durable weight reduction.

  • 3.

    For patients with BMI 30–35 who do not achieve substantial and durable weight and co-morbidity

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      Since the National Institutes of Health consensus conference, new procedures have been introduced and laparoscopy has largely replaced open surgery, with higher levels of scientific evidence now available regarding the health hazards of obesity and the improved risks and benefits of bariatric surgery [46,47]. Given the major changes that have occurred in this field, it is appropriate to review the data now available, and in the context of bariatric surgery as it is currently practiced, consider modification of the arbitrary recommendations established >25 years ago [1]. Despite attempts to update the recommendations of the original guidelines [7,8], private health insurers and Medicare continue to rely on the 1991 consensus conference guidelines to set a baseline for BMI above which bariatric surgery offers a favorable risk/benefit ratio.

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      Bariatric surgery traditionally has been recommended for severely obese patients with a body mass index (BMI) of ≥ 40 kg/m2 or for severely obese patients with BMI of ≥ 35 kg/m2 with at least 1 co-morbid condition. More recently, the indications have been expanded to include obese patients with a BMI of 30 ≥ kg/m2 and a metabolic condition, such as type 2 diabetes (Ponce et al., 2015; Brethauer, 2013). Improvement in glycemic control after bariatric surgery can be either weight loss dependent and independent.

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