OSSI (Obesity and Metabolic Surgery Society of India) Guidelines for Patient and Procedure Selection for Bariatric and Metabolic Surgery

Bhasker, Aparna Govil; Prasad, Arun; Raj, Praveen; Wadhawan, Randeep; Khaitan, Manish; Agarwal, AK; Tantia, Om; Baig, Sarfaraz Jalil; Palaniappan, Rajkumar; Shivram, H V; Shah, Shashank; Soni, Vandana; Bhandari, Mohit; Shivahare, R; Dhorepatil, Shrihari; Chowbey, Pradeep; Narwaria, Mahendra; Khullar, Rajesh

doi:10.1007/s11695-020-04497-1

Cited by 14 publications

(42 citation statements)

References 34 publications

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“…The statement of the National Institutes of Health in 1991 [1] has not been changed despite the tremendous changes in BMS practice over the last 30 years. The panel at that time decided the current cut-off (BMI > 40 or 35-40 kg/m 2 with OAMP for bariatric surgery without the support of evidencebased data, but based on the balance between the risk and benefit of limited open bariatric surgery at that time) [3]. We believe that the main reason for not lowering the cut-off for surgery was the economic and national regularity conditions rather than the safety of the procedure, as already the action BMI cut points are reduced by 2.5 kg/ m 2 to BMI 27.5, 32.5, and 37.5 kg/m 2 for Asian populations due to ethnic liability for obesity-associated medical problems [15].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The safety and effectiveness of the metabolic effect of bariatric and metabolic surgery (BMS) in patients with mild obesity have been thoroughly investigated in the literature especially in patients with T2DM and in Asian populations due to ethnic liability for OAMP. This has led different international and national BMS societies to recommend surgery in patients with class 1 obesity who do not achieve substantial and durable weight and OAMP improvement with nonsurgical methods [2][3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness and Safety of Laparoscopic Sleeve Gastrectomy for Weight Loss in Mild Obesity: Prospective Cohort Study with 3-Year Follow-up

et al. 2022

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Purpose Patients with mild obesity especially in absence of associated medical problems (OAMP) are commonly managed by non-surgical approaches. Laparoscopic sleeve gastrectomy (LSG) has proved itself to be effective and it is now the most performed weight loss procedure. We aimed to study the effectiveness and safety of LSG for weight loss in mild obesity. Methods A prospective cohort study. Group A; BMI (30–34.9 kg/m2), and group B; BMI ≥ 40 or BMI ≥ 35 with OAMP. Demographic data, perioperative complications, % excess weight loss (EWL), % total weight loss (TWL), nutritional profile, and evolution of OAMP were recorded and statistically analyzed. Results A total of 250 patients, with 80 patients (32%) in group A, and 170 (68%) in group B. The majority were female. The mean preoperative weight, BMI, and excess weight were 90.1 ± 9.52, 32.7 ± 1.4, and 21.5 ± 4.9 in group A, and 129.88 ± 26.12, 47.8 ± 8.2, and 62.3 ± 23.6 kg in group B respectively. The low BMI group had significantly lower OAMP, with higher pre-LSG non-surgical procedures rate. Overall post-operative morbidity rate was significantly higher in group B. %TWL was significantly lower in low BMI group. Nutritional profile was within the normal range in both groups at 3-year follow-up. Conclusion Laparoscopic sleeve gastrectomy is a safe and effective weight loss solution for mild obesity with better outcome than for higher BMI. Further studies are warranted to reconsider NIH’s statement for medicolegal aspects, and for matching the current changes in bariatric surgery practice, safety evidence, and patients’ demand. Graphical abstract

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effectiveness and Safety of Laparoscopic Sleeve Gastrectomy for Weight Loss in Mild Obesity: Prospective Cohort Study with 3-Year Follow-up

et al. 2022

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“…Non-alcoholic fatty liver disease (NAFLD) is one the most prevalent chronic liver diseases due to worldwide increase in the prevalence of obesity [1,2]. In India, obesity is taking a big leap and hence proportionately there is a rise in NAFLD as well [3][4][5]. NAFLD increases risk of liver-related morbidity and mortality because of development of non-alcoholic steatohepatitis (NASH), cirrhosis, and hepatocellular carcinoma [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic sleeve gastroplasty — minimally invasive treatment for non-alcoholic fatty liver disease and obesity

Jagtap

Kalapala

Katakwar

et al. 2021

Indian J Gastroenterol

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Introduction Adequate weight loss can lead to reduction in steatosis, inflammation, and fibrosis in patients with obesity and nonalcoholic fatty liver disease (NAFLD). We evaluated the role of endoscopic sleeve gastroplasty (ESG) in patients with obesity and NAFLD. Methods In this single-center prospective study, consecutive adult patients with NAFLD who underwent ESG between November 2018 and May 2019 were included. The primary outcome was the impact of ESG on hepatic parameters: change in alanine aminotransferase (ALT), hepatic steatosis index (HSI), NAFLD fibrosis score (NFS), fibrosis-4 index (FIB-4), and aspartate aminotransferase (AST)-to-platelet ratio index (APRI) from baseline to 6 and 12 months. Secondary outcomes included change in glycated hemoglobin (HbA1c), percentage weight loss, and safety. Analysis of variance with repeated measures was used for statistical analysis. Results A total of 26 patients (mean age [SD] 41.5 [9.58] years; 16 females) with mean (SD) weight of 99.43 (21.89) kg at baseline were included. There was significant improvement in ALT (mean ± SD) from baseline of 59.54 ± 17.02 IU/L to 49.50 ± 11.72 IU/L and 48.42 ± 13.22 IU/L at 6 and 12 months (p = 0.001). Mean (SD) NFS was significantly improved from 0.228 (1.00) at baseline to −0.202 (1.16) and −0.552 (1.08) at 6 and 12 months (p 0.001). Mean (SD) HSI, FIB-4, and APRI scores significantly reduced from baseline to 6 and 12 months (p = 0.001). There was 18.07% total body weight loss at 12 months, with significant improvement in HbA1c. There were no major adverse events. Conclusion ESG is a safe and effective treatment option for patients with NAFLD and obesity causing significant weight loss. Rigorous randomized trials are required to incorporate ESG in NAFLD treatment algorithm.

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“…OSSI upholds the BMI criteria for bariatric and metabolic surgery of 2011 IFSO-APC guidelines. In addition waist circumference of ≥ 80 cm in females and ≥ 90 cm in males was added along with obesity related co-morbidities for surgery 93 . Not all individuals with T2DM experience remission after bariatric surgery.…”

Section: B Bariatric Surgerymentioning

confidence: 99%

RSSDI Clinical Practice Recommendations for the Management of Type 2 Diabetes Mellitus 2022

2022

Int J Diabetes Dev Ctries

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OSSI (Obesity and Metabolic Surgery Society of India) Guidelines for Patient and Procedure Selection for Bariatric and Metabolic Surgery

Cited by 14 publications

References 34 publications

Effectiveness and Safety of Laparoscopic Sleeve Gastrectomy for Weight Loss in Mild Obesity: Prospective Cohort Study with 3-Year Follow-up

Effectiveness and Safety of Laparoscopic Sleeve Gastrectomy for Weight Loss in Mild Obesity: Prospective Cohort Study with 3-Year Follow-up

Endoscopic sleeve gastroplasty — minimally invasive treatment for non-alcoholic fatty liver disease and obesity

RSSDI Clinical Practice Recommendations for the Management of Type 2 Diabetes Mellitus 2022

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