Criteria for bariatric surgery referral

What the decision turns on

Bariatric surgery is a treatment of adult obesity, and whether a patient is sent for it turns on two short lists: first the inclusion criteria, then the exclusion criteria. Both have to be met, and a referral question is made by putting up a BMI that meets one list beside a problem that falls on the other.

Inclusion criteria

Inclusion criteria for bariatric surgery are two:

• A BMI of 40 kg/m2 or more without coexisting medical problems
• A BMI of 35 kg/m2 or more with one or more severe obesity-related comorbidities, such as diabetes mellitus

So the BMI needed is not one number. It falls from 40 kg/m2 to 35 kg/m2 once a severe obesity-related comorbidity is present.

Exclusion criteria

Exclusion criteria are four:

• Active substance abuse
• Uncontrolled severe psychiatric illness
• Severe cardiopulmonary disease that makes the surgical risk prohibitive
• Lack of cognitive function to comprehend the associated risks, benefits and required lifestyle changes