Statement on metabolic and bariatric surgery during COVID-19 pandemic

June 23, 2020

Newberry, Fla. -- Jun. 23, 2020 -- The American Society for Metabolic and Bariatric Surgery (ASMBS), the leading organization of bariatric surgeons and integrated health professionals in the nation, declared metabolic and bariatric surgery "medically necessary and the best treatment for those with the life-threatening and life-limiting disease of severe obesity" and called for the safe and rapid resumption of procedures, which have been largely postponed along with other surgeries deemed elective amid the COVID-19 pandemic.

In a SOARD, the ASMBS strongly rejects classifying metabolic and bariatric surgery as "elective" and prefers the use of the term "Medically Necessary Time-Sensitive Surgery" or "Medically Necessary Non-Emergent Surgery" to better characterize the effectiveness of the intervention and the progressive nature of the many diseases it treats including obesity, type 2 diabetes, hypertension and heart disease.

"COVID-19 may be a factor for quite some time and the longer the treatment of obesity, type 2 diabetes and other related diseases are postponed, the greater the chance they will become worse," said Matthew M. Hutter, MD, MPH, president of the ASMBS and professor of surgery at Harvard Medical School. "Each state, doctor and patient must make a decision as to when conditions for metabolic and bariatric surgery are right, but the sooner it can be safely performed, the more quickly obesity, type 2 diabetes and other diseases can be reduced or resolved."

The ASMBS recommends that the precise timing for surgery be carefully considered based on factors including an individual patient's health status, local prevalence of COVID-19 and the availability of resources including hospital beds, ventilators and personal protective equipment (PPE).

The ASMBS statement concludes, "Before COVID-19 began, it was clear that patients with obesity were 'safer through surgery'. In the era of COVID-19, 'safer through surgery' for patients with obesity may prove to be even more important than before." Obesity has been identified as an independent risk factor for adverse outcomes including death among COVID-19 patients.

Metabolic/bariatric surgery has been shown to be the most effective and long-lasting treatment for severe obesity.1 Its safety profile is comparable to some of the safest and most commonly performed surgeries in the U.S. including gallbladder surgery, appendectomy and knee replacement.2

An estimated 252,000 bariatric surgeries were performed in the United States in 2018, which is approximately less than 1 percent of the population eligible for surgery based on BMI.3 The U.S. Centers for Disease Control and Prevention (CDC) reports 42.4 percent of Americans had obesity in 2017-2018.4 Obesity has been linked to more than 40 diseases including type 2 diabetes, hypertension, heart disease, stroke, sleep apnea, osteoarthritis and at least 13 different types of cancer.5,6,7
-end-
About the ASMBS

The ASMBS is the largest organization for bariatric surgeons in the nation. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of severe obesity, as well as the associated risks and benefits. It encourages its members to investigate and discover new advances in bariatric surgery, while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for patients with severe obesity. For more information, visit
http://www.asmbs.org.

1 Weiner, R. A., et al. (2010). Indications and principles of metabolic surgery. U.S. National Library of Medicine. 81(4) pp.379-394. https://www.ncbi.nlm.nih.gov/pubmed/20361370

2 Gastric Bypass is as Safe as Commonly Performed Surgeries. Health Essentials. Cleveland Clinic. Nov. 6, 2014. Accessed October 2017 https://health.clevelandclinic.org/2014/11/gastric-bypass-is-as-safe-as-commonly-performed-surgeries/

3https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers

4https://www.cdc.gov/obesity/data/adult.html

5 The Effectiveness and Risks of Bariatric Surgery: An Updated Systematic Review and Meta-analysis, 2003-2012. Accessed from: https://jamanetwork.com/journals/jamasurgery/fullarticle/1790378

6 Steele CB, Thomas CC, Henley SJ, et al. Vital Signs: Trends in Incidence of Cancers Associated with Overweight and Obesity -- United States, 2005-2014. MMWR Morb Mortal Wkly Rep 2017;66:1052-1058. DOI: http://dx.doi.org/10.15585/mmwr.mm6639e1

7 Centers for Disease Control and Prevention. (2015) The Health Effects of Overweight and Obesity. Accessed from: https://www.cdc.gov/healthyweight/effects/index.html

American Society for Metabolic and Bariatric Surgery

Related Bariatric Surgery Articles from Brightsurf:

Statement on metabolic and bariatric surgery during COVID-19 pandemic
The American Society for Metabolic and Bariatric Surgery (ASMBS), the leading organization of bariatric surgeons and integrated health professionals in the nation, declared metabolic and bariatric surgery 'medically necessary and the best treatment for those with the life-threatening and life-limiting disease of severe obesity' and called for the safe and rapid resumption of procedures, which have been largely postponed along with other surgeries deemed elective amid the COVID-19 pandemic.

Examining association between weight loss before bariatric surgery, risk of death after surgery
Researchers looked at whether a patient's body weight and weight loss before bariatric surgery were associated with risk of death within 30 days after surgery using data from nearly 500,000 patients in the US and Canada.

Bariatric surgery effective against early-onset obesity too
Surgical treatment of obesity is as effective for individuals who developed the disorder early, by the age of 20, as for those who have developed obesity later in life, a study from the University of Gothenburg shows.

Lower risk for malignant melanoma after bariatric surgery
Bariatric surgery is associated with a distinct reduction in skin-cancer risk, a study shows.

Study shows risks for additional procedures after bariatric surgery
Which of the two most common bariatric surgeries -- gastric sleeve or gastric bypass -- has the highest subsequent risk of additional operations or procedures?

Studies continue to highlight benefits of bariatric surgery in teens
Children's Colorado researchers and their colleagues found that musculoskeletal pain, physical function and quality of life in adolescents significantly improves and is maintained three years after bariatric surgery.

Bariatric surgery may not lead to lower health care costs
Despite helping to bring about improved survival and significant weight loss, bariatric surgery may not lead to lower health care costs in the long term, says a Veterans Affairs study.

Bariatric surgery is safe for teens with morbid obesity
Bariatric surgery is safe and, in many cases, beneficial for teenagers with morbid obesity who would otherwise face a heightened risk of developing severe health problems, including heart disease and stroke, according to a new study from Penn Medicine and the Children's Hospital of Philadelphia (CHOP).

Criteria for bariatric surgery should consider more than just patient's weight
More than one-third of Americans are obese, and while more than 250,000 bariatric surgeries are performed annually in the United States, experts at The Ohio State University Wexner Medical Center and 45 worldwide scientific and medical societies say surgery should be an option for many more patients.

Bariatric surgery can be safe and effective for adolescents
Pediatricians are often reluctant to recommend bariatric surgery for teen-agers, but a Rutgers-led study concludes it is a justifiable treatment for adolescents with persistent extreme obesity if they can maintain a healthy lifestyle afterward.

Read More: Bariatric Surgery News and Bariatric Surgery Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.