Expert panel on weight loss surgery: executive report update.
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.
Blackburn
George L
GL
Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. gblackbu@bidmc.harvard.edu
Hutter
Matthew M
MM
Harvey
Alan M
AM
Apovian
Caroline M
CM
Boulton
Hannah R W
HR
Cummings
Susan
S
Fallon
John A
JA
Greenberg
Isaac
I
Jiser
Michael E
ME
Jones
Daniel B
DB
Jones
Stephanie B
SB
Kaplan
Lee M
LM
Kelly
John J
JJ
Kruger
Rayford S
RS
Lautz
David B
DB
Lenders
Carine M
CM
Lonigro
Robert
R
Luce
Helen
H
McNamara
Anne
A
Mulligan
Ann T
AT
Paasche-Orlow
Michael K
MK
Perna
Frank M
FM
Pratt
Janey S A
JS
Riley
Stancel M
SM
Robinson
Malcolm K
MK
Romanelli
John R
JR
Saltzman
Edward
E
Schumann
Roman
R
Shikora
Scott A
SA
Snow
Roger L
RL
Sogg
Stephanie
S
Sullivan
Mary A
MA
Tarnoff
Michael
M
Thompson
Christopher C
CC
Wee
Christina C
CC
Ridley
Nancy
N
Auerbach
John
J
Hu
Frank B
FB
Kirle
Leslie
L
Buckley
Rita B
RB
Annas
Catherine L
CL
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