Weight loss can be accomplished by decreasing the capacity of
the stomach with a gastric band or through extirpation of a
part of the stomach or by exterminating and re-routing the small
intestine to a mini stomach pouch. Long-term studies show the procedures cause
significant long-term loss of weight, recovery from diabetes, improvement in
cardiovascular risk factors, and a mortality reduction from 40% to 23%. The
U.S. National Institutes of Health recommends bariatric surgery for obese
people with a body mass index (BMI) of at least 40, and for people with BMI of
at least 35 and serious coexisting medical conditions such as diabetes.
However, research is emerging that suggests bariatric surgery could be
appropriate for those with a BMI of 35 to 40 with no comorbidities or a BMI of
30 to 35 with significant comorbidities. The most recent American Society for
Metabolic & Bariatric Surgery guidelines suggests the position statement on
consensus for BMI as an indication for bariatric surgery.