Selecting patients for bariatric surgical treatment for obesity

5a. Adults with a BMI of > 40 or BMI of > 35 with obesity-related comorbidities, who are not motivated to lose weight or have not responded to behavioral treatment or pharmacotherapy, may be appropriate candidates for bariatric surgery. (Evidence Grade A-Strong)

5b. There is insufficient evidence to recommend for or against bariatric surgery for individuals with BMI <35. (Evidence Grade N-No Recommendation)


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5c. Advise patients that choice of a specific bariatric surgical procedure may be affected by numerous factors (eg, age, severity of obesity, comorbid conditions, risk factors, behavioral/psychosocial factors, and provider factors). (Evidence Grade E-Expert Opinion)

Treatment Algorithm: The Chronic Disease Model for Primary Care of Patients With Overweight and Obesity

The Guideline provides an algorithm for the management of patients with overweight and obesity in the primary care setting. (Figure 1)

Treatment Algorithm

For more information, please click here to see the full guide: “2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults.”

Conclusion

The Panel members expressed their hope that the “guidelines will garner the widest possible readership for the benefit of patients, providers, and the public health.”

References

1. Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults: A Report of the American College of Cardiology/American Hearth Association Task force on Practice Guidelines and the Obesity Society. Available at: http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437739.71477.ee.full.pdf+html. Accessed: December 9, 2013.

2. National Institutes of Health. National Heart, Lung, and Blood Institute (NHLBI). Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. Available at: http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf. Accessed: December 5, 2013.

3. International Diabetes Federation (IDF). The IDF consensus worldwide definition of the metabolic syndrome. (1998) Available at: http://www.idf.org/webdata/docs/MetSyndrome_FINAL.pdf. Accessed: December 9, 2013.


To look at any of the articles in this series, click below.

Part 1: Cardiovascular Risk Assessment
Part 2: Lifestyle Management
Part 3: Panel Member Addresses Controversies Surrounding New Cholesterol Guideline
Part 4: Management of Overweight and Obesity in Adults