Criteria for Bariatric Surgery Should Consider More Than Just Patient’s Weight

Thousands of patients who don’t meet BMI to qualify would benefit from surgery

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(COLUMBUS, Ohio) – More than one-third of Americans are obese, and while more than 250,000 bariatric surgeries are performed annually in the United States, experts at The Ohio State University Wexner Medical Center and 45 worldwide scientific and medical societies say surgery should be an option for many more patients. Dr. Stacy Brethauer says the standard criteria to qualify for bariatric surgery are nearly three decades old and are arbitrarily based on a patient’s body mass index (BMI). For example, if there are two patients with uncontrolled diabetes, the one with a BMI of 35 will qualify for surgery, while the patient with a BMI of 34 is often denied by insurance companies, he said.

    “The patient who doesn’t get the operation, we know very well that their disease will progress and their lifespan will be shortened,” said Brethauer, a surgeon at Ohio State Wexner Medical Center’s Bariatric Surgery Center of Excellence. “Continuing to increase their insulin requirements will not change the trajectory of the disease. Surgery does.”     

     That disease progression not only comes with complications of diabetes, but may include conditions such as heart disease and cancer. “You wouldn’t wait until a patient has advanced-stage cancer to treat their disease, and the same should be true for obesity,” said Brethauer. “Too many see obesity as a problem of willpower, and it’s simply not. Patients must participate in their care by making healthy lifestyle changes, but the most effective treatment is often surgery, and that should be an option for patients who would benefit.”

     Multiple clinical studies have proven the benefits of bariatric surgery in patients with lower BMIs, and the American Society for Metabolic and Bariatric Surgery have drafted new criteria that would make these patients eligible. Brethauer says it’s now up to referring physicians and insurance companies to more widely adopt these new standards so that more patients can receive the treatment they need.

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Dr. Stacy Brethauer consults with a patient considering bariatric surgery at The Ohio State University Wexner Medical Center. Brethauer says bariatric surgery should be an option for more patients, rather than relying on outdated qualifications that are solely based on body mass index.

Shaun Rogers says living a healthy lifestyle and controlling his diabetes is much easier after bariatric surgery, an option he didn’t think would be available to him with a body mass index of just 35 before surgery.

Dr. Stacy Brethauer performs bariatric surgery at The Ohio State University Wexner Medical Center. He is urging referring physicians and insurance companies to more widely adopt new standards so that more patients can receive the treatment they need to prevent obesity related diseases like diabetes from becoming worse.

Shaun Rogers takes an insulin shot at his Columbus, Ohio home. After having bariatric surgery, he lost 120 pounds, discontinued all oral medications and got his diabetes under control.

Shaun Rogers is able to stay active and healthy after dropping 120 pounds. Shaun didn’t think his BMI was high enough to qualify for bariatric surgery, but experts at The Ohio State University Wexner Medical Center say offering surgery as an option to patients with lower BMIs can prevent obesity related diseases like diabetes from advancing.