Beyond the BMI: the search for better guidelines for bariatric surgery.
The application of the BMI of > or =35 as the major prerequisite for access to bariatric surgery is no longer appropriate because the index, now incorporated in the requirements of Medicare, Medicaid and most private carriers, does not reflect the degree or distribution of adiposity, it discriminates unfairly on the basis of gender, race, age, fitness, and body fat composition. Further, with increasing evidence that bariatric surgery can also induce full and durable remission of such comorbidities as type 2 diabetes even in patients with BMIs <30, new guidelines must be pursued.
Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA. Pories@aol.com
Walter J
WJ
Pories
Lynis G
LG
Dohm
Christopher J
CJ
Mansfield
D050154:Adiposity / Q000502:physiology*; D000367:Age Factors; D050110:Bariatric Surgery / Q000592:standards*; D015992:Body Mass Index; D006801:Humans; D009767:Obesity, Morbid / Q000601:surgery*; D017410:Practice Guidelines as Topic; D012737:Sex Factors