Are you a candidate for surgery?

Indications for obesity surgery and weight-related disorders: position statements of the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) and the American Society for Metabolic and Bariatric Surgery:

• BMI ≥ 40, or more than 100 pounds overweight.

• BMI ≥ 35 and at least one or more obesity-related comorbidities, such as type II diabetes (DM2), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease.

• Surgical weight loss treatment improves the components of metabolic syndrome. This applies to patients with class I obesity (BMI > 30 kg/m2) as well as to patients with higher obesity classes.

• Long-standing obesity (> 5 years)

• Proven failure of nutritional and behavioral therapy. Inability to achieve sustained, healthy weight loss over a period of time with previous weight loss efforts.

• Surgery for obesity and weight-related diseases is effective in obese patients under 18 years of age.

• Surgery for obesity and weight-related disorders is effective in obese patients over 60 years of age. Most studies conclude that the primary goal of surgery for obesity and weight-related disorders in patients over 60 years of age is to improve quality of life.

• In 2007, European interdisciplinary guidelines, in agreement with the views expressed by a document of American pediatricians, endorsed the use of surgery for obese patients younger than 18 years, supportive surgery for obesity and weight-related diseases only for patients whose BMI > 40 kg/m 2 (or > 99.5th percentile for age) with at least one comorbidity.

• Mood and anxiety disorders are not considered contraindications for surgery. Mood and anxiety symptoms should be carefully monitored both before and after surgery. Hence the importance of having a multidisciplinary team involved in the patient's treatment.

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