New Guidelines For Weight Loss Surgery - What’s Changed?

Here we are at the beginning of another new year. For many, a new year comes with goals of weight loss and health. Some may struggle to achieve their goals through diet and exercise alone. For them, bariatric surgery, otherwise known as weight loss surgery, may be an option.

Authorities Change Guidelines for Bariatric and Metabolic Surgery

In 2022 two leading authorities for bariatric surgery, the American Society for Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) updated the Guidelines on Indications for Metabolic and Bariatric Surgery.

The guidelines set the standard doctors use to make decisions regarding who should have weight loss surgery, what kind of weight loss surgery they should have, and when they should have it.

Since the guidelines were first published, over 30 years ago, metabolic and bariatric surgery have made significant advances, both in terms of the technology available, and our knowledge.  Now we have a deeper understanding of obesity and its related co-morbidities which has transformed how we treat the disease. The new evidence-based, clinical guidelines reflect these advances.  

Here we discuss the new guidelines, what’s different and what that might mean to you.

What’s Changed In Matabolic and Bariatric Guidelines?   

1. Lower BMI Cut-off.

The earlier guidelines required the patient to have a BMI greater than 40 or, at least 35 if they have at least one obesity-linked co-morbidity like heart disease or hypertension. The new guidelines, however, have lowered these BMI requirements.  

The new guidelines recommend metabolic and bariatric surgery for those with a BMI greater than 35 even without co-morbidities. Also, while the previous guidelines didn’t mention metabolic surgery, the new guidelines say that metabolic and bariatric surgery may be considered for individuals with metabolic disease (i.e., type 2 diabetes) who have a BMI of 30-34.9 who have not been able to lose weight or improve their co-morbidities through nonsurgical methods.

2. Change To BMI Thresholds By Population.

The new guidelines recommend obesity definitions are adjusted by population. They recommend that Asian individuals may consider weight loss surgery from a BMI of 27.5.

3. Consideration of Children/Adolescents.

The previous guidelines expressly recommended against bariatric surgery for children, even with a BMI above 40. At the time there was not enough evidence to support it.  The new guidelines state that metabolic and bariatric surgery should be considered for “appropriately selected” children/adolescents.

4. Highlight The Safety And Efficacy Of Modern-day Metabolic And Bariatric Surgery.

The new guidelines highlight data collected in the last 30 years, supporting the safety and effectiveness of metabolic and bariatric surgery. This data includes randomised clinical trials, clinical studies, and patient experiences on a global scale. They also state that the data shows that metabolic and bariatric surgery gives better weight loss outcomes compared to non-surgical treatments.

The 2022 guidelines mention the body of evidence showing that metabolic and bariatric surgery helps to reduce metabolic disease and decrease obesity-related deaths. The guidelines point out that safer and more effective operations have replaced older techniques.  

5. Consideration Of Metabolic Surgery.

As mentioned above the original guidelines make no mention of metabolic surgery. The new guidelines make surgery available to type 2 diabetic patients, with lower BMIs. These patients would not previously have been considered.

What Does That Mean For Me?

Well, if you’re hoping to qualify for bariatric surgery, it could mean a lot to you.  The ASMBS refer to the previous guidelines as “overly restrictive” and believe they limited the use of metabolic and bariatric surgery for many who could have benefited.  

By expanding the criteria needed to qualify for bariatric surgery, the new guidelines mean more people can have surgery by taking a more individualised approach to qualification.  

As discussed above, the changes to the guidelines reflect our increasing knowledge of obesity, its complicated, multifaced nature, and its impact on health and well-being.  

How Can Doctor Lockie Help?

The new guidelines allow us to support a wider variety of patients to achieve their health goals and improve their quality of life. They also highlight the safety and effectiveness of modern-day metabolic and bariatric surgery.

We’re here to help you make lasting changes so you can live the life you want without feeling so weighed down.

If you’d like to learn more about how bariatric surgery could help you, please book a free initial consultation today.

*All information is general and is not intended to be a substitute for professional medical advice. Dr. Phil Lockie can consult with you to confirm if a particular treatment is right for you. Any surgical or invasive procedure carries risks.