New Guidelines Broaden Eligibility for Bariatric Surgery

Stronger Emphasis on Diabetes; Sleeve Gastrectomy Gets Nod

In a major shift in policy, three major medical societies have changed their formal guidelines for bariatric surgery and expanded eligibility to include patients with mild to moderate obesity and diabetes or metabolic syndrome.

Additionally, the societies—the American Society for Metabolic and Bariatric Surgery, the American Association of Clinical Endocrinologists and the Obesity Society—upgraded sleeve gastrectomy from investigational status to a “proven surgical option.”

The changes will bring the U.S. guidelines in line with practices increasingly used around the country and reflect evidence that has emerged in the four years since the previous guideline was developed.

“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 Daniel B. Jones, MD, professor of surgery, Harvard Medical School, Boston, and one of a 12-member panel that developed the guidelines.

“Our goal was to make it a little easier for the practitioner to understand how strong the data are in favor of a practice, whether that be a psychological evaluation or a preoperative check of calcium and thiamine levels.”

The guidelines were published online March 25 in the journals of the three organizations: Endocrine Practice, Obesity andSurgery for Obesity and Related Diseases. They cover perioperative nutritional, metabolic and nonsurgical support for bariatric surgery patients.

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