Journal of the American College of Nutrition, Vol 11, Issue 4 457-462, Copyright © 1992 by American College of Nutrition

JOURNAL ARTICLE

Morbid obesity: selection of patients for surgery

M. Deitel and B. Shahi
Department of Surgery, University of Toronto, St. Joseph's Health Centre, Canada.

Massive obesity is associated with serious co-morbidities. After failure of extensive conservative measures, surgical procedures have developed as the only successful method for sustained weight loss. Criteria for operation are: presence of serious diseases associated with morbid obesity; greater than 45 kg above ideal weight or body mass index greater than 40 kg/m2 for usually greater than 5 years; failure of sustained weight loss on extensive conservative regimens; commitment to lifelong follow-up; and acceptable operative risk. Angina pectoris itself is not a contraindication to these operations. Patients who do not quite meet the weight criteria may still be candidates for an obesity operation in certain instances, e.g., debilitating musculoskeletal pains in weight-bearing joints, diabetes, significant hypertension, reflux esophagitis, urinary stress incontinence. Although current operations result in lasting weight loss of greater than 50% of excess weight in the majority of patients, the surgical candidate must understand and accept the principles of the procedures, the potential for serious complications, the dietary necessities, and occasional failures.

This article has been cited by other articles:

				M. Deitel and S. A. Shikora The Development of the Surgical Treatment of Morbid Obesity J. Am. Coll. Nutr., October 1, 2002; 21(5): 365 - 371. [Abstract] [Full Text] [PDF]

				S. E. Greenway, F. L. Greenway III, and S. Klein Effects of Obesity Surgery on Non-Insulin-Dependent Diabetes Mellitus Arch Surg, October 1, 2002; 137(10): 1109 - 1117. [Abstract] [Full Text] [PDF]