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Bariatric Surgery in Class I Obesity: A Position Statement from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO)

Busetto, Luca, Dixon, John, De Luca, Maurizio, Shikora, Scott, Pories, Walter, Angrisani, Luigi·2014·Obesity Surgery

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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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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
ORCID: Busetto, Luca
Dixon, John
Shikora, Scott
Pories, Walter
Angrisani, Luigi
Venue: Obesity Surgery
Publisher: Springer Science and Business Media LLC
Published: 2014-03-18
Volume: 24
Issue: 4
Pages: 487-519
ISSN: 0960-8923 (ISSN-L)
1708-0428
DOI: 10.1007/s11695-014-1214-1
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 › Medicine › Public Health, Environmental and Occupational Health › 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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Bariatric Surgery in Class I Obesity: A Position Statement from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO)

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