Bariatric Surgery in Class I Obesity: A Position Statement from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO)
Abstract
Class I obesity conveys an increased risk of comorbidities, impairs physical and mental health-related quality of life, and it is associated to an increased psychosocial burden, particularly in women. The need for effective and safe therapies for class I obesity is great and not yet met by nonsurgical approaches. Eligibility to bariatric surgery has been largely based on body mass index (BMI) cut points and limited to patients with more severe obesity levels. However, obese patients belonging to the same BMI class may have very different levels of health, risk, and impact of obesity on quality of life. Individual patients in class I obesity may have a comorbidity burden similar to, or greater than, patients with more severe obesity. Therefore, the denial of bariatric surgery to a patient with class I obesity suffering from a significant obesity-related health burden and not achieving weight control with nonsurgical therapy simply on the basis of the BMI level does not appear to be clinically justified. A clinical decision should be based on a more comprehensive evaluation of the patient's current global health and on a more reliable prediction of future morbidity and mortality. After a careful review of available data about safety and efficacy of bariatric surgery in patients with class I obesity, this panel reached a consensus on ten clinical recommendations.
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In the Asian population, the prevalence of diabetes and cardiovascular disease is higher at a lower BMI than in the non-Asian population.
“In the Asian population the prevalence of diabetes and cardiovascular disease is higher at a lower BMI than in the non-Asian population.”
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COVID-19: IFSO LAC Recommendations for the Resumption of Elective Bariatric Surgery
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One-anastomosis gastric bypass with a short limb
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Is It Time to Lower the Bar for Bariatric Surgery?
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Bariatrische Eingriffe in der Therapie des Diabetes mellitus Typ II
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Busetto, L., Angrisani, L., Luca, M. D., Forestieri, P., Millo, P., & Santini, F. (2015) · Springer eBooks · doi:10.1007/978-3-319-24532-4_6 · Cited by 1 · see citing works
Self-citationIndications for Bariatric Surgery
Lucchese, M., Quartararo, G., Godini, L., Sturiale, A., & Facchiano, E. (2015) · Springer eBooks · doi:10.1007/978-3-319-15356-8_13 · Cited by 1 · see citing works
Current Indications to Bariatric Surgery in Adult, Adolescent, and Elderly Obese Patients
Busetto, L., Sbraccia, P., & Santini, F. (2016) · Updates in surgery/Updates in surgery series · doi:10.1007/978-88-470-3944-5_2 · Cited by 1 · see citing works
Self-citationImpact of self‐efficacy on risk aversion in the context of surgical weight loss decision scenarios
Turner, M. M., Johnson, A. C., & Lantz, P. M. (2019) · Clinical Obesity · doi:10.1111/cob.12311 · Cited by 1 · see citing works
Yao, G., Aierken, A., Li, T., Cao, X., Apaer, S., Anweier, N., Wu, J., Fulati, X., Zhang, Y., Tuerxunmaimaiti, A., et al. (2022) · Medicine · doi:10.1097/md.0000000000030783 · Cited by 1 · see citing works
Almasi, M. H., Barzin, M., Khalaj, A., Mahdavi, M., Valizadeh, M., & Hosseinpanah, F. (2024) · Research Square · doi:10.21203/rs.3.rs-4312540/v1 · Cited by 1 · see citing works
Rubio, M. Á. (2014) · Avances en Diabetología · doi:10.1016/j.avdiab.2014.06.005
Maglio, C. (2014) · Gothenburg University Publications Electronic Archive (Gothenburg University)
Abril, G., & Ángel, S. (2015) · Dialnet (Universidad de la Rioja)
Definition of Outcomes After Bariatric Surgery
Kow, L. (2017) · Springer eBooks · doi:10.1007/978-981-10-2705-5_5
Partie VII — La chirurgie bariatrique, sinon rien ? Fogel–Étude ICAPS (2008–2014)
Dargent, J. (2018) · Obésité · doi:10.3166/obe-2018-0030
- Authors
- Busetto, L., Dixon, J., De Luca, M., Shikora, S., Pories, W., & Angrisani, L.
- Affiliations
- University of Padua (IT)
- Baker Heart and Diabetes Institute (AU)
- Brigham and Women's Hospital (US)
- East Carolina University (US)
- Ospedale San Giovanni Bosco (IT)
- Corresponding author
- Busetto, Luca
- Venue
- Obesity Surgery
- Published
- 2014-03-18
- Volume
- 24
- Issue
- 4
- Pages
- 487-519
- ISSN
- 0960-8923 (ISSN-L)
- 1708-0428
- OpenAlex
- W7875930
- Cited by
- 118
- References
- 209
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 15 · 2023: 8 · 2022: 7 · 2021: 6 · 2020: 10 · 2019: 8 · 2018: 9 · 2017: 8 · 2016: 17 · 2015: 20 · 2014: 7
- FWCI
- 17.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Obesity Surgery (publishedVersion)
- PubMed (publishedVersion)
- Padua Research Archive (University of Padova) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Keywords
- bariatric surgery, class I obesity
- MeSH terms
- Humans, Life Style, Metabolic Diseases, Obesity, Obesity, Morbid, Quality of Life, Comorbidity, Body Mass Index, Treatment Outcome, Anti-Obesity Agents, Bariatric Surgery
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