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Some Slightly Obese May Gain From Weight-Loss Surgery, Guidelines Say

Medical groups lower threshold for body-fat levels in new recommendations

TUESDAY, April 16 (HealthDay News) -- Even people who are slightly obese could be candidates for weight-loss surgery under new guidelines released by three U.S. medical groups.

The groups recommended that eligibility for weight-loss (bariatric) surgery be expanded to include mildly to moderately obese people with diabetes or metabolic syndrome, which is a group of conditions that put people at increased risk for heart disease and diabetes.

Under the new rules, eligible patients would have a body-mass index (BMI) of 30 to 34.9. BMI is a measurement of body fat based on height and weight.

There is not enough current evidence, however, to recommend weight-loss surgery for blood sugar control alone, fat lowering alone or heart disease risk reduction alone, independent of BMI criteria, the guidelines said.

The American Society for Metabolic and Bariatric Surgery, the American Association of Clinical Endocrinologists and the Obesity Society issued the guidelines. They were published in the latest editions of the journals Surgery for Obesity and Related Diseases, Endocrine Practice and Obesity.

Among the 74 recommendations in the guidelines:

  • Sleeve gastrectomy is reclassified as a proven method of weight-loss surgery, rather than an experimental one.
  • Women should avoid pregnancy before weight-loss surgery and for 12 to 18 months after surgery.
  • A team approach to patient care around the time of surgery is "mandatory with special attention to nutritional and metabolic issues."

Other recommendations cover topics such as patient screening and selection, deciding on the best type of weight-loss surgery, and criteria for readmitting patients to the hospital after they've had weight-loss surgery.

The previous guidelines were issued in 2008.

"Bariatric or metabolic surgery is among the most studied surgical interventions in medicine and this ever-increasing mountain of evidence continues to show that these procedures are the most successful and durable treatment for obesity and several related diseases," Dr. Daniel Jones, a member of the 12-person panel that developed the guidelines, said in a news release from the American Society for Metabolic and Bariatric Surgery.

"However, we've gleaned important new insights, cautions and best practices based on the thousands of studies that were published in medical journals in just the last four years alone and these are reflected in the new guidelines," said Jones, a professor of surgery at Harvard Medical School.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about weight-loss surgery.


SOURCE: American Society for Metabolic and Bariatric Surgery, news release, April 5, 2013

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