The National Institute for Clinical Excellence has issued recommendations to the NHS on the use of gastric surgery for the treatment of morbid obesity.
For the purposes of the NICE guidance, people are considered to have morbid obesity if they have a body mass index (BMI) of 40 kg/m2 or more or they have a BMI of between 35 kg/m2 and 40 kg/m2 and other significant disease (for example, diabetes, high blood pressure) that may be improved if they lose weight.
NICE has recommended that surgery to aid weight loss should be available as a treatment option for people with morbid obesity provided that they meet all of the following criteria:
they are aged 18 years or over
they have been receiving treatment in a specialist obesity clinic at a hospital
they have tried all other appropriate non-surgical treatments to lose weight but have not been able to maintain weight loss
there are no specific medical or psychological reasons why they should not have this type of surgery
they are generally fit enough to have an anaesthetic and surgery
they should understand that they will need to be followed-up by a doctor and other healthcare professionals such as dieticians or psychologists over the long-term.
People with morbid obesity should have surgery to aid weight loss only after they have had a full assessment by the specialist and other healthcare professionals involved in their care. In addition, counselling and support should be arranged for people before and after the surgery.
The NICE guidelines state that bariatric surgery should be offered to patients with a body mass index (BMI) of 35-40 who have other conditions caused by being overweight, such as diabetes and obstructive sleep apnea, those with a BMI of 40-50 with no other weight related conditions or those with a BMI of 50 and over, as a first-line treatment.
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