New guidelines open up weight-loss surgery to more Americans struggling with obesity

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Tuesday, September 5, 2023
New guidelines open up weight-loss surgery to more Americans
For the first time in 30 years, the world's leading authorities have new guidance on who will benefit from weight-loss surgery.

NORTH PHILADELPHIA (WPVI) -- Millions of Americans qualify for bariatric surgery. However, many more could benefit from it.

New guidelines could mean a green light for them.

"We're going to have this exciting webinar, It's going to serve actually as the formal release of the new guidelines," came the announcement from the American Society of Metabolic and Bariatric Surgery and the International Federation for the Surgery of Obesity of during an online meeting.

It was a landmark occasion: for the first time in 30 years, the two leading authorities on weight-loss surgery issued new guidance for bariatric surgery.

Unlike those from 1991, these guidelines are based in science, not opinion.

"They represent the best data out there, and the best practices there is of how to do safe, minimally invasive metabolic and bariatric surgery," said surgeon Dr. Scott Shikora.

Bariatric surgeon Charis Ripley-Hager of Temple Health says the new guidelines recognize that reversing obesity takes more than willpower.

"Medical weight loss, diet, exercise - these are great, but they are not sufficient for just about anyone with a BMI over 35," says Dr. Ripley-Hager.

Nor do they work for those less obese, with conditions like high blood pressure, high cholesterol, type 2 diabetes, or sleep apnea.

It also recognizes the struggle of those who lose a lot of weight in keeping it off.

People used to need a BMI of 35-40 with medical conditions, and 40 or more without other factors to get surgery.

Now, the new guidelines set the bar at 30-35 with major conditions, and 35 and over without.

Dr. Ripley-Hager says it also allows surgery for Asian Americans with major conditions at a BMI of 27.

"We're starting to realize that we are not all exactly the same," she notes.

The new standards also acknowledge that with most bariatric surgery done through small incisions or with robot helpers, it's extremely safe.

"The complication rate from bariatric surgery nowadays is roughly equivalent to gallbladder surgery," says Dr. Ripley-Hager.

She says the new guidelines are gradually being adopted.

"Some insurances are approving, some are giving us pushback. It's in process," notes the doctor.

Likewise with other physicians.

"We're actively going out and discussing this with the primary care doctors," she says.

"In some parts of Philadelphia, we're only reaching .6% of the people who are eligible under the old guidelines," she says of the need to spread the word about bariatric surgery in our area.

Dr. Ripley-Hager hopes more people will take advantage of the surgery, to bring down their heart, diabetes, and cancer risks - and to just feel better overall.