Despite the effectiveness of bariatric surgery, utilization rates have increased only marginally over the last two decades; candidates who are eligible for bariatric surgery regularly fail to undergo surgery. The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) has previously been used to assist in identification of those who will not move forward with surgery after being identified as eligible. However, medical insurance has been identified as a significant barrier to surgery; research in those who have universal healthcare may yield different results ..read more

Multiple prediction models exist in the literature to aide both the patients and providers taking care of patients undergoing bariatric surgery.(1–5) For patients, these models help with understanding predicted ranges of weight loss, comorbidity reduction, and complication risk. Furthermore, their use creates a dialogue of shared decision making with increased patient understanding of bariatric surgery risks and benefits. As stated by Burgard et al, it is known that about 40% of patients will overestimate their post-operative weight loss.(5) For providers, prediction models aide in counseling ..read more

Metabolic bariatric surgery (MBS) not only leads to a durable weight loss but also lowers mortality, and reduces cardiovascular risks ..read more

Taking into consideration rising rates of childhood obesity US,1 and recent reports demonstrating the safety, efficacy and increased utilization rates of metabolic and bariatric surgery (MBS) for clinically eligible pediatric patients (BMI ≥ 120% of the 95th percentile or BMI ≥ 35kg.m2),2 the authors of the current study, Enhanced Recovery After Surgery (ERAS) Improves Clinical Outcomes in Adolescent Bariatric Surgery, have offered important insights by presenting the results of a single institutional experience related to the use of an enhanced recovery after surgery (ERAS) protocol ..read more

In this issue of Surgery of Obesity and Related Diseases,Corpodean, et al. describe the prevalence of emergency bariatric surgery within the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) dataset from 2015 to 2021, with a comparison of cases recorded before and after a change in the MBSAQIP definition of emergency cases, which occurred in 2020 (i.e. 2015-2019 compared to 2020-2021). The study found there to be 10,574 emergency cases (∼2,115 per year) from 2015-2019 and 455 emergency cases (∼228 per year) from 2020-2021 ..read more

The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) was initiated in 2015 under the auspices of the American College of Surgeons and began with 742 participating centers in the United States and Canada to ensure quality surgical care.[1] Since then, the program has grown to over 900 centers and tracks 30-day outcomes for over 200,000 patients annually.[1] The program is costly: participating centers must pay to participate and employ 3rd-party surgical clinical reviewers to abstract data into the database ..read more

Elevated glycosylated hemoglobin (HbA1c) is a modifiable risk factor for postoperative complications. However, in bariatric surgery, as published by our group and others, elevated preoperative HbA1c may not be associated with increased postoperative complications. Previous literature has focused on primary bariatric surgery and has excluded the higher risk revisional surgery cohort ..read more

Sleeve gastrectomy (SG) is the most commonly performed weight loss operation and its two most common complications are postoperative reflux and weight recurrence. There is limited evidence to guide decision-making in treating these conditions ..read more

The myriad of benefits from metabolic and bariatric surgery (MBS) include long-term mitigation of obesity-associated medical comorbidities, improved quality of life, and increased life expectancy. The 1991 NIH consensus development conference panel published MBS patient selection guidelines over 30 years ago with limited studies and general clinical knowledge about obesity-related health issues. Since the 1980s, there has been an explosion in research studies looking at the positive impact of MBS on obesity-related medical problems ..read more

Has there ever been a period of great medical uncertainty, such as in the early days of the COVID-19 pandemic? There were so many unanswered questions at the time and very little practical information available to decision-makers, both at the national level and within our specialty of bariatric surgery. For almost a year, surgeons were shut out of our operating rooms and worked the front lines in the battle against this new foe. As hospitals reopened their doors to elective surgery and surgeons came to grips with the new reality of post-COVID triage of preoperative patients, rules for returnin ..read more