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Bariatric surgery is the surgical discipline dealing with management of morbid obesity. Q

  1. Indications for Bariatric Surgery
    1. Non-surgical means of losing weight are effective in achieving 5-15% body weight loss. Q
    2. In patients of lower BMI ie. <35 kg/m2, this small percentage of weight loss helps to achieve significant improvement in obesity – related comorbid conditions such as diabetes and hypertension.
    3. However, patients with BMI>35 kg/m2 with co-morbidities and BMI>40 kg/m2 do not do well with non-surgical means of weight loss.
    4. Despite losing weight, they still fall in the obese category and stay at a high-risk due to obesity.
    5. Patient qualify for bariatric surgery according to NIH consensus conference 1996 are:.
      1. BMI ≥ 40 kg/m2                      
      2. BMI ≥ 35 kg/m2 with two associated co-morbidities
Recommended BMI values for bariatric surgery in Asians.
  1. BMI ≥ 37.5 kg/m2           
  2. BMI ≥ 32.5 kg/m2 with two associated co-morbidities.



Ref: Schwartz's Principles of Surgery 9th Edition Ch 27

  1. LAGB (Laparoscopic Adjustable Gastric Banding) : It is reversible with high safety. So it is the safest bariatric surgical procedure today. Q
  2. Bowel transposition is not a surgical option for bariatric surgery (Bowel transposition surgical option for short bowel syndrome). Q
  3. BPD i.e.Biliopancreatic diversion with duodenal switch has shown the best results.Q

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