Obesity is defined by a Body Mass Index (BMI) greater than 30. Body mass index is calculated by a person’s weight in kilograms divided by their height in meters squared (BMI = weight/height2 or kg/m2). This can also be calculated by a person’s weight in pounds divided by their height in inches squared multiplied by a correction factor (lbs/inches2 X 703).
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BMI Range
| < 25 25-30 30-35 35-40 > 40 |
Normal Overweight Obesity, Class 1 Severe Obesity, Class 2 Morbid obesity, Class 3 |
Most surgeons and insurance companies use the guidelines established by the National Institutes for Health (NIH) in 1991. The NIH guidelines for weight loss surgery are as follows:
Body Mass Index (BMI) > 40
OR
BMI 35 - 40 with 2 or more obesity-related medical conditions
Patients of all ages undergo Laparoscopic Adjustable Gastric Band (LAP-BAND, REALIZE Band) surgery. Older patients can undergo band surgery provided they are in a good state of health to tolerate anesthesia. Since childhood obesity is a growing problem, we have an adolescent program to offer younger patients as well.
Since obese patients are clearly at increased risk for multiple potentially life threatening medical conditions, there is universal agreement that substantial, long lasting weight loss should be the treatment goal for obesity. We know that the majority of obesity-related medical conditions will resolve or significantly improve with substantial, sustained weight loss.
The decision to recommend surgical treatment for weight loss requires a careful assessment of the risks and benefits in each individual case. There are occasionally patients who would benefit from weight loss surgery despite the fact that they do not strictly meet the NIH guidelines. Ideally patients are well informed, motivated, and have acceptable operative risks. They should be able to participate in treatment and long term follow-up. Although rare, we sometimes must decline a patient for surgery if we feel they are too high a risk for surgery and/or anesthesia. The preoperative psychology evaluation simply serves the purpose of helping patients plan for the emotional changes that occur with massive weight loss. Occasionally, the psychology evaluation will identify patients with untreated depression. In that case, we simply postpone surgery until their depression is successfully treated.
9075 Centre Pointe, Suite #160, West Chester, OH 45069
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