title: Expert panel on weight loss surgery: executive report update.
abstract: Rapid shifts in the demographics and techniques of weight loss surgery (WLS) have led to new issues, new data, new concerns, and new challenges. In 2004, this journal published comprehensive evidence-based guidelines on WLS. In this issue, we've updated those guidelines to assure patient safety in this fast-changing field. WLS involves a uniquely vulnerable population in need of specialized resources and ongoing multidisciplinary care. Timely best-practice updates are required to identify new risks, develop strategies to address them, and optimize treatment. Findings in these reports are based on a comprehensive review of the most current literature on WLS; they directly link patient safety to methods for setting evidence-based guidelines developed from peer-reviewed scientific publications. Among other outcomes, these reports show that WLS reduces chronic disease risk factors, improves health, and confers a survival benefit on those who undergo it. The literature also shows that laparoscopy has displaced open surgery as the predominant approach; that government agencies and insurers only reimburse procedures performed at accredited WLS centers; that best practice care requires close collaboration between members of a multidisciplinary team; and that new and existing facilities require wide-ranging changes to accommodate growing numbers of severely obese patients. More than 100 specialists from across the state of Massachusetts and across the many disciplines involved in WLS came together to develop these new standards. We expect them to have far-reaching effects of the development of health care policy and the practice of WLS.
authors.affiliation: Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. gblackbu@bidmc.harvard.edu
authors.forename: George L
authors.initials: GL
authors.lastname: Blackburn
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Hutter
authors.forename: Alan M
authors.initials: AM
authors.lastname: Harvey
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Apovian
authors.forename: Hannah R W
authors.initials: HR
authors.lastname: Boulton
authors.forename: Susan
authors.initials: S
authors.lastname: Cummings
authors.forename: John A
authors.initials: JA
authors.lastname: Fallon
authors.forename: Isaac
authors.initials: I
authors.lastname: Greenberg
authors.forename: Michael E
authors.initials: ME
authors.lastname: Jiser
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Jones
authors.forename: Stephanie B
authors.initials: SB
authors.lastname: Jones
authors.forename: Lee M
authors.initials: LM
authors.lastname: Kaplan
authors.forename: John J
authors.initials: JJ
authors.lastname: Kelly
authors.forename: Rayford S
authors.initials: RS
authors.lastname: Kruger
authors.forename: David B
authors.initials: DB
authors.lastname: Lautz
authors.forename: Carine M
authors.initials: CM
authors.lastname: Lenders
authors.forename: Robert
authors.initials: R
authors.lastname: Lonigro
authors.forename: Helen
authors.initials: H
authors.lastname: Luce
authors.forename: Anne
authors.initials: A
authors.lastname: McNamara
authors.forename: Ann T
authors.initials: AT
authors.lastname: Mulligan
authors.forename: Michael K
authors.initials: MK
authors.lastname: Paasche-Orlow
authors.forename: Frank M
authors.initials: FM
authors.lastname: Perna
authors.forename: Janey S A
authors.initials: JS
authors.lastname: Pratt
authors.forename: Stancel M
authors.initials: SM
authors.lastname: Riley
authors.forename: Malcolm K
authors.initials: MK
authors.lastname: Robinson
authors.forename: John R
authors.initials: JR
authors.lastname: Romanelli
authors.forename: Edward
authors.initials: E
authors.lastname: Saltzman
authors.forename: Roman
authors.initials: R
authors.lastname: Schumann
authors.forename: Scott A
authors.initials: SA
authors.lastname: Shikora
authors.forename: Roger L
authors.initials: RL
authors.lastname: Snow
authors.forename: Stephanie
authors.initials: S
authors.lastname: Sogg
authors.forename: Mary A
authors.initials: MA
authors.lastname: Sullivan
authors.forename: Michael
authors.initials: M
authors.lastname: Tarnoff
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Thompson
authors.forename: Christina C
authors.initials: CC
authors.lastname: Wee
authors.forename: Nancy
authors.initials: N
authors.lastname: Ridley
authors.forename: John
authors.initials: J
authors.lastname: Auerbach
authors.forename: Frank B
authors.initials: FB
authors.lastname: Hu
authors.forename: Leslie
authors.initials: L
authors.lastname: Kirle
authors.forename: Rita B
authors.initials: RB
authors.lastname: Buckley
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Annas
mesh_terms: D050110:Bariatric Surgery / Q000009:adverse effects / Q000379:methods / Q000592:standards*; D019317:Evidence-Based Medicine / Q000592:standards; D005743:Gastrectomy / Q000379:methods; D015390:Gastric Bypass / Q000379:methods; D006291:Health Policy; D006801:Humans; D008404:Massachusetts; D008511:Medicine; D009765:Obesity / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D010348:Patient Care Team; D010353:Patient Education as Topic; D018579:Patient Selection; D012051:Reimbursement Mechanisms; D012307:Risk Factors; D013038:Specialization; D017741:Survivors; D014481:United States; D015431:Weight Loss