Indications for surgery for obesity and weight-related diseases: position statements from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) and the American Society for Bariatric and Metabolic 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, nonalcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or kidney disease. heart.
• 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 patients with higher class obesity.
• Long-term 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 diseases is effective in obese patients over 60 years of age. Most studies conclude that the primary goal of surgery for obesity and weight-related diseases in patients over 60 years of age is to improve quality of life.
• In 2007, European interdisciplinary guidelines, based on opinions expressed by a document by American pediatricians, endorsed the use of surgery for obese patients under 18 years of age, 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 to 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 treatment of the patient.

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