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Indications and Contraindications for Bariatric Surgery

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The ASMBS Textbook of Bariatric Surgery

Abstract

Defining the indications for metabolic and bariatric surgery begins with an assessment of the risk-benefit ratio of a given procedure against that of morbid obesity. Significant advances in surgical techniques, reductions in operative risk, and greater knowledge of the harmful sequelae of untreated obesity have greatly altered the risk-benefit ratio of surgery since the 1991 NIH consensus statement. In addition, the health and mortality risk of untreated obesity is better defined and higher than was previously appreciated. The result is a shift in the risk-benefit analysis favoring surgery, leading to consideration of lowering the body mass index (BMI) indications for metabolic and bariatric surgery. There are few absolute contraindications to metabolic and bariatric surgery. Most would be included in lists of contraindications of any elective surgical procedure. Patients deemed to have a prohibitive operative risk should not be offered surgery. Bariatric surgery should not be performed on patients with limited life expectancy. Patients who are pregnant or who expect to be pregnant should be deferred. Active drug or alcohol abuse is a relative contraindication to surgery, as is untreated severe psychiatric illness. In the appropriate patient population, however, bariatric surgery is one of the safest elective surgeries.

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Author information

Authors and Affiliations

  1. Division of Bariatric & General Surgery, University of South Florida, Tampa, FL, USA

    Christopher DuCoin

  2. Moore Metabolics & Tulane University Department of Surgery, New Orleans, LA, USA

    Rachel L. Moore

  3. Division of General and Bariatric Surgery, Baylor Scott & White Medical Center, Temple, TX, USA

    David A. Provost

Authors
  1. Christopher DuCoin
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  2. Rachel L. Moore
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  3. David A. Provost
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Corresponding author

Correspondence to Christopher DuCoin .

Editor information

Editors and Affiliations

  1. Department of Surgery, Division of Gastrointestinal Surgery, University of California, Irvine Medical Center, Orange, CA, USA

    Ninh T. Nguyen

  2. Department of Surgery, The Ohio State University, Columbus, OH, USA

    Stacy A. Brethauer

  3. Bariatric and Minimally Invasive Surgery Division, Yale School of Medicine, New Haven, CT, USA

    John M. Morton

  4. Bariatric Surgery, Metabolic and Bariatric Care, CHI Memorial Hospital, Chattanooga, TN, USA

    Jaime Ponce

  5. Department of General Surgery, The Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, FL, USA

    Raul J. Rosenthal

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DuCoin, C., Moore, R.L., Provost, D.A. (2020). Indications and Contraindications for Bariatric Surgery. In: Nguyen, N., Brethauer, S., Morton, J., Ponce, J., Rosenthal, R. (eds) The ASMBS Textbook of Bariatric Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-27021-6_6

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  • DOI: https://doi.org/10.1007/978-3-030-27021-6_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-27020-9

  • Online ISBN: 978-3-030-27021-6

  • eBook Packages: MedicineMedicine (R0)

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