new 2024 bariatric surgery guidelines, recommendations, and statistics

New Bariatric Surgery Guidelines and Statistics 2024

For the first time in over 30 years, experts in the field of bariatric and metabolic surgery have released new clinical practice guidelines. These 2022 guidelines from the American Society for Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) aim to update eligibility and recommendations for weight-loss surgery to reflect the latest evidence and global experience gathered since the original 1991 NIH consensus statement.

With obesity now recognized as a chronic disease, the new guidelines expand patient access to metabolic and bariatric surgery, endorsing it for a wider range of patients. Specifically, they lower the minimum body mass index (BMI) threshold and recommend considering surgery for patients with type 2 diabetes who have not responded sufficiently to lifestyle and medical management. This marks an important shift to make weight-loss surgery available to more individuals struggling with obesity and metabolic disease.

Key Guideline Updates Expand Patient Eligibility

The updated ASMBS/IFSO guidelines recommend metabolic and bariatric surgery for individuals with a BMI of 35 or higher, regardless of the presence or severity of co-morbid obesity-related conditions like diabetes and hypertension. This replaces the older BMI threshold of 40 set in 1991.

Additionally, the experts suggest considering weight-loss surgery for patients with a BMI between 30-34.9 who also have metabolic disease like type 2 diabetes, if lifestyle changes and medical management have not led to sufficient improvement. This is a major shift to make surgery accessible for more individuals with class I obesity.

The new bariatric surgery guidelines also note that BMI thresholds should be adjusted for Asian populations, with obesity defined starting at 25 kg/m2. Appropriately selected adolescents may also now be candidates for metabolic surgery based on these recommendations.

Bariatric Surgery Trends Over the Years

Understanding trends in bariatric surgery can give insights into the growing popularity or decline of each procedure. Below is a table illustrating the number of surgeries performed from 2011 to 2021:

Here's the statistics for bariatric surgeries performed over a ten year period:

Year	Gastric Sleeve	RYGB	Lap Band	BPD-DS
2021	152,866	56,527	1,121	5,525
2020	122,056	41,280	2,393	3,555
2019	152,413	45,744	2,375	2,272
2018	154,976	42,945	2,660	2,123
2017	135,401	40,574	6,318	1,588
2016	125,318	40,316	7,310	1,236
2015	105,448	45,276	11,172	1,176
2014	99,781	51,724	18,335	772
2013	75,359	61,218	25,060	1,790
2012	57,090	64,875	34,946	1,730
2011	28,124	57,986	55,932	1,422

Key takeaways from this table:

Gastric Sleeve surgeries have seen a substantial increase, peaking in recent years.
Roux-en-Y Gastric Bypass (RYGB) has remained fairly steady but is less common compared to the sleeve.
Lap Band surgeries have seen a significant decline.
Biliopancreatic Diversion with Duodenal Switch (BPD-DS) is the least common and has minor fluctuations over the years.

Patient Profiles

Demographic	Percentage or Average	Details
Gender (Female)	78%	Predominantly female patients
Average Age	37 years	Mean age of patients
Mean BMI	43.51	Body mass index average
High Blood Pressure	51%	Most prevalent comorbidity

Outcomes After Surgery

Outcome	Statistic	Details
Long-term Weight Loss	Substantial and durable	Weight loss is significant and maintained long-term
Reoperation Likelihood	Common	Reoperation remains common across all procedures
Weight Loss (3 Years Post-Op)	Significant	Marked improvement or remission of obesity-related health conditions
30-Day Complication Rate	4.6%	Study conducted during 2020 and 2021
Severe Complications	3%	Includes anastomotic/staple line leakage, stenosis, pulmonary embolism
Mortality Rate	0.2%	Death occurs in a small percentage of patients

Conclusion

The new rules from top experts make it easier for more people to get weight-loss surgery. These rules are based on the latest science and will help more folks struggling with weight and related health issues like diabetes. The data also shows some surgeries are getting more popular, while others are less common now.

Bottom line: More people can now consider weight-loss surgery as a real option for improving their health. This is big news that could change—and maybe even save—more lives. Keep an eye out for what comes next, as the medical field keeps learning and evolving.