Patient Selection for Bariatric Surgery - Surgery abroad with Globe Health Tours.

Understanding Patient Selection Criteria for Bariatric Surgery

The option of surgical treatment should be offered to patients who are

morbidly obese,
well informed,
motivated,
acceptable operative risks.
Patient should be able to participate in treatment and long term follow-up.

Some patients with manifest psychopathology that jeopardises an informed consent and cooperation with long-term follow-up may need to be excluded from surgery.

A decision to elect surgical treatment requires an assessment of the risk and benefit in each case. Increased abdominal fat or “central obesity” (apple shaped as opposed to pear shaped) is an important risk factor associated with the major complications of obesity. Functional impairments associated with obesity are also important deciding factors for surgical treatment. An important conclusion of the 1991 National Institutes Consensus Development Conference Statement on the surgical treatment of obesity was that “patients judged by experienced clinicians to have a low probability of success with non-surgical measures, as demonstrated, for example, by failure in established weight control programs or reluctance by the patient to enter such a program, may be considered for surgical treatment”.

Patients whose BMI exceeds 40 are potential candidates for surgery if they strongly desire substantial weight loss, because obesity severely negatively impacts the quality of their lives. They must clearly and realistically understand how their lives may be changed after a bariatric surgery operation.

In certain circumstances, less severely obese patients (with BMI’s between 35 and 40) also may be considered for surgery. Included in this category are patients with high risk co-morbid conditions such as life threatening cardiopulmonary problems (e.g. severe sleep apnea, Pickwickian syndrome, obesity related cardiomyopathy, or severe diabetes mellitus). Other possible indications for patients with BMI’s between 35 and 40 include obesity-induced physical problems that are interfering with lifestyle (e.g. musculoskeletal or neurologic or body size problems precluding or severely interfering with employment, family function and ambulation).

End stage obesity syndrome

Some candidates for surgical treatment of severe obesity have such impaired health that they must be hospitalized pre-operatively and undergo treatment to improve their operative risk.