nutritional disorders
Metabolic and Bariatric Surgery
Indications for Bariatric Surgery
In 2022, the American Society for Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) updated recommendations for metabolic and bariatric surgery to include patients with a BMI>35 kg/m2 regardless of comorbidities and those with a BMI 30 to 34.5 kg/m2 with metabolic disorders. Comorbidities include the following: Type 2 diabetes None Hypertension None Dyslipidemia None Obstructive Sleep Apnea (OSA) None Cardiovascular disorders Asthma None Metabolic dysfunction-associated Metabolic Dysfunction–Associated Liver Disease (MASLD) and steatohepatitis Chronic Kidney Disease None Polycystic Ovary Syndrome (PCOS) None Overview of Infertility None Gastroesophageal Reflux Disease (GERD) None Pseudotumor cerebri Bone and joint disorders The updated recommendations also specify that BMI thresholds should be adjusted in Asian populations and that patients with a BMI ≥ 27.5 kg/m2 should be offered surgery ( Indications reference ). Metabolic and bariatric surgery is offered as part of a weight-loss program that usually includes Provider seminar classes Psychological assessment of the patient Consultation with a surgeon Consultation with registered dietitians Routine laboratory tests Screening for obstructive sleep apnea (OSA) Operative risk stratification Contraindications include An uncontrolled psychiatric disorder such as Major depressive disorder (unipolar depressive disorder) None Current substance or alcohol use disorder Cancer that is not in remission Another life-threatening disorder Inability to comply with nutritional requirements, including life-long vitamin replacement (when indicated) 1.Eisenberg D, Shikora SA, Aarts E, et al: 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): Indications for metabolic and bariatric surgery.Surg Obes Relat Dis18 (12):1345-1356, 2022. doi: 10.1016/j.soard.2022.08.013 Epub 2022 Oct 21. 