Weight Loss Surgery: Who and When?

Without doubt, the questions regarding who should be considered for weight-loss surgery and at what point have long been major debates in the world of bariatric surgery. Obesity is now considered a global epidemic by the World Health Organization. It is a condition that causes several serious health problems and is responsible for 5% of all deaths globally.

Up until now, bariatric surgery was only considered for an obese patient once the rest of the weight loss treatments had failed and there was no reliable data on the difference between the effects of surgical and non-surgical procedures available.

At the end of 2014, an extensive literature review was published in the prestigious Cochrane Library with the objective of comparing the various procedures used for the treatment of obesity and to verify the effects of bariatric surgery on overweight and obese patients, including the control of comorbidity. Surgical and non-surgical (pharmacological treatment, diets and exercise) approaches were compared and, at the same time, the results between the different surgical procedures were also studied.

The review concluded that those patients who underwent bariatric surgery achieved greater weight loss and an improvement in the comorbidities associated to weight, regardless of what type of surgical procedure was carried out.  Furthermore, it determined that weight loss surgery should be recommended sooner rather than later for patients with a body mass index (BMI = kg/m²) greater than 40, or for those with a BMI less than 40 who suffer from obesity-related diseases such as diabetes.


Surgery for weight loss in adults (Review) – Colquitt JL, Pickett K, Loveman E, Frampton GK – published in The Cochrane Library

2014, Issue 8

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