New Guidelines Recommends Weight-Loss Surgery For Those With BMI Over 30 – Indians develop obesity-related metabolic diseases at much lower weight and BMI. Bariatric surgery helps reduce complications linked to obesity.

Anyone with a body-mass index (BMI) of over 30 should be considered for bariatric surgery, whether or not they have obesity-related medical problems, according to the new guidelines for weight-loss surgery. Earlier, in the 1991 consensus statement, only those whose BMI is 40 or higher (extreme obesity) or BMI of 35 or more (obesity) and having a weight-related health problem such as hypertension or heart disease were qualified for the surgery.

After 30 years, the American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) have laid down new evidence-based clinical guidelines for weight-loss surgery and lowered the BMI threshold.

What is Bariatric surgery?

Bariatric surgery is a collective term of weight-loss surgeries that involve changing the anatomy of the gastrointestinal tract including the stomach and digestive system to help people lose excess weight and reduce their risk of weight-related health conditions. It is usually done when diet and exercise haven’t helped the person to lose weight.

There are different types of bariatric surgery including gastric bypass, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch. While some of these weight-loss procedures work by limiting the amount of food you can eat, others focus on reducing the body’s ability to absorb nutrients and some do both. Your surgeon will decide the best weight-loss procedure for you depending on your specific situation.

Obesity raisesrisk of many other diseases

Obesity or having excessive amount of body fat is a serious medical problem that can put a person at risk of many other potentially life-threatening health problems including heart disease, high blood pressure, stroke, obstructive sleep apnea, type 2 diabetes, nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH), gallbladder disease, gastroesophageal reflux disease (GERD), and osteoarthritis.

A sedentary lifestyle can make your pile up excess kilos, stated Dr Manish Motwani, Chief Bariatric Surgeon at Aastha Bariatrics, Centre of Excellence in Metabolic and Bariatric Surgery.

The best way to treat obesity is to consider it a disease and each grade of obesity has a different treatment. Bariatric surgery is a scientific procedure/treatment performed on obese patients to reduce excessive weight from the body. It can transform a person’s life, he added.

Meanwhile, Dr Aparna Govil Bhasker, Bariatric and laparoscopic surgeon, Saifee, Apollo Spectra, Namaha and Currae Hospitals, Mumbai, has raised concern about the alarming rise in incidence of obesity in the country during the pandemic.

New Guidelines for Bariatric surgery

The new ASMBS/IFSO guidelines expand patient eligibility for weight-loss surgery and recommends metabolic surgery for people with type 2 diabetes beginning at a BMI of 30. Before, diabetes was not included in screening criteria for metabolic and bariatric surgery.

Also, the 1991 consensus statement did not recommend such surgery in children and adolescents even with BMIs over 40 as there were limited studies done on these age group. Now, the new guidelines recommend bariatric surgery for individuals with a BMI of 35 or more regardless of the presence, absence, or severity of obesity-related conditions as well as considering such procedures for those with a BMI 30 34.9 and metabolic disease and in appropriately selected children and adolescents.

Improvement in Bariatric surgery

According to Dr Motwani, the first obesity surgery or bariatric surgery was performed in India in 1997/ 1998. At that time, the surgery was performed by open incision (making a big, long incision to open the stomach or abdomen). Now, it is done through laparoscopy or keyhole surgery, by making multiple small holes on the stomach and inserting a telescope inside the abdomen. The surgeries are performed using laparoscopic instruments or long thin instruments.

Dr Aparna noted that Indians develop obesity-related metabolic diseases like type 2 diabetes, heart disease, high cholesterol and high blood pressure at much lower weight and BMI.

She stated that bariatric/metabolic surgery is the most effective treatment for people with morbid obesity and metabolic syndrome, and hopes that new guidelines will help many eligible patients to avail its health benefits and get timely intervention. Home

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