Lower BMI Candidates Undergoing Weight Loss Surgery
A recent study finished in March of 2009 in surgical endoscopy described the outcomes with surgery in people with a lower Body Mass Index than the current standard widely accepted criteria (normally a Body Mass Index of 35 or greater qualifies people for weight loss surgery at most U.S. centers).
In this study, 53 patients with a Body Mass Index ranging from 28 to 35 underwent laparoscopic adjustable gastric banding surgery. In the study, the patients lost 69% of excess body weight at six months. This rose to 77% at 12 months and 81% of excess body weight was lost at the two-year mark. The mean Body Mass Index was 33 at the beginning of the study and then fell to 25.8 at the two-year mark.
Even more importantly, 50% of the patients with diabetes mellitus experienced complete resolution of their diabetes. (Fifteen patients total started with type II diabetes.) 45% of patients with hypertension experienced resolution of this condition. Similar results were seen with asthma and obstructive sleep apnea.
Over the two-year course of the study, 13% of patients experienced some type of problem or complication including one patient with a band slip, two with fluid causing band obstruction, two with esophagitis and two with port leaks.
This most recent study adds further evidence that weight loss surgery is safe and effective for people with a lower Body Mass Index than is widely accepted. The implications of this sort of research finding are quite profound. Many additional tens of millions of Americans and hundreds of millions worldwide would qualify under an expanded BMI criterion.
This study and other like it show that people who are moderately obese stand to improve their health and resolve very serious conditions such as type II diabetes, obstructive sleep apnea, hypertension and asthma with the help of weight loss surgery. Should the criteria be expanded? Should health insurance plans pay for this surgery for this vast number of people who would qualify under expanded criteria?
Perhaps it is better to offer the weight loss surgery to people at a lower BMI and take a more proactive or preventive approach to the serious diseases they will soon develop. One might argue that they might also be expected to have lower risk for surgery at this earlier stage of the obesity disease rather than waiting until they have full-blown obesity with many complications like severe heart and lung disease (which make them higher risk for surgery and anesthesia).
In the future, we will see a debate over whether the current criteria for weight loss surgery need to be expanded and then who would pay for the procedures and programs.