BMI criteria for obesity surgery should be lowered, UT Southwestern researchers suggest

December 18, 2007

DALLAS - Dec. 18, 2007 - UT Southwestern Medical Center researchers have found that the existing body mass index criteria for obesity surgery often excludes a group of obese patients at risk of cardiovascular disease.

The study, appearing in the December issue of the journal Surgery for Obesity and Related Diseases, is among the first to evaluate the risk-factor relationship between body mass index (BMI) and cardiovascular disease as it relates to bariatric surgery criteria, said Dr. Edward Livingston, chairman of GI/endocrine surgery at UT Southwestern and lead author of the study.

"Our results show that cardiovascular risk factors do not necessarily worsen with increasing obesity," Dr. Livingston said. "They also support the concept that obesity, by itself, doesn't trigger an adverse cardiovascular risk profile or increased risk of death."

The researchers examined patient data from the Third National Health and Nutrition Examination Survey database for the presence of known cardiovascular risk factors as a function of obesity. The survey was a cross-sectional study conducted from 1988 to 1994. All 17,234 participants had a BMI greater than 20.

BMI is a weight-to-height ratio commonly used in doctors' offices to gauge obesity. A normal BMI is between 18.5 and 25, whereas someone with a BMI of 40 or more is at least 100 pounds over their recommended weight and is considered morbidly obese.

Bariatric weight-loss surgery is currently recommended for patients with a BMI greater than 40, as well as for patients with a BMI greater than 35 who also suffer from a life-threatening illness, such as non-insulin dependent diabetes, sleep apnea or heart disease.

The study findings show that some morbidly obese patients have better cardiovascular disease risk profiles than those who are less obese. In particular, the researchers found that cardiovascular risk factors can be much worse in many individuals with a BMI as low as 30 than they are for some surgical candidates with higher BMIs.

This suggests that some patients who are obese but not morbidly obese could benefit from bariatric surgery, which can help reduce cardiovascular disease, said Dr. Livingston.

Dr. Nicola Abate, associate professor of internal medicine in the Center for Human Nutrition at UT Southwestern and the study's co-author, said it's possible that very obese patients simply have a greater capacity to store excessive calories in their adipocytes, or fat cells, thereby preventing excessive fat from spilling into the bloodstream, where it contributes to heart disease.

"Our findings suggest that there is a group of individuals who have an almost unlimited ability to store excess calories as fat. This prevents changes in plasma metabolites, such as triglycerides and cholesterol, which promote risk for heart disease," Dr. Abate said. "In contrast, those who can't store as much fat and who only accumulate fat in the upper body often have excessive plasma concentrations of triglycerides and cholesterol, which will increase their risk for heart disease. Even though their BMI may be below the current recommended cutoff, these patients could potentially benefit from bariatric surgery."
-end-
Dr. Manisha Chandalia, associate professor of internal medicine in the Center for Human Nutrition, co-authored the study.

Visit http://www.utsouthwestern.org/patientcare/medicalservices/bariatrics.html to learn more about UT Southwestern's clinical services in bariatrics.

This news release is available on our World Wide Web home page at http://www.utsouthwestern.edu/home/news/index.html

To automatically receive news releases from UT Southwestern via e-mail, subscribe at www.utsouthwestern.edu/receivenews

Dr. Edward Livingston - http://www.utsouthwestern.edu/findfac/professional/0,2356,58399,00.html

Dr. Nicola Abate - http://www.utsouthwestern.edu/findfac/professional/0,2356,20228,00.html

UT Southwestern Medical Center

Related Obesity Articles from Brightsurf:

11 years of data add to the evidence for using testosterone therapy to treat obesity, including as an alternative to obesity surgery
New research covering 11 years of data presented at this year's European and International Congress on Obesity (ECOICO 2020) show that, in obese men suffering from hypogonadism (low testosterone), treatment with testosterone injections lowers their weight and improves a wide range of other metabolic parameters.

Overlap between immunology of COVID-19 and obesity could explain the increased risk of death in people living with obesity, and also older patients
Data presented in a special COVID-19 session at the European and International Congress on Obesity (ECOICO 2020) suggests that there are overlaps between the immunological disturbances found in both COVID-19 disease and patients with obesity, which could explain the increased disease severity and mortality risk faced by obese patients, and also elderly patients, who are infected by the SARS-CoV-2 virus that causes COVID-19 disease.

New obesity guideline: Address root causes as foundation of obesity management
besity management should focus on outcomes that patients consider to be important, not weight loss alone, and include a holistic approach that addresses the root causes of obesity, according to a new clinical practice guideline published in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.191707.

Changing the debate around obesity
The UK's National Health Service (NHS) needs to do more to address the ingrained stigma and discrimination faced by people with obesity, says a leading health psychologist.

Study links longer exposure to obesity and earlier development of obesity to increased risk of type 2 diabetes
Cumulative exposure to obesity could be at least as important as actually being obese in terms of risk of developing type 2 diabetes (T2D), concludes new research published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]).

How much do obesity and addictions overlap?
A large analysis of personality studies has found that people with obesity behave somewhat like people with addictions to alcohol or drugs.

Should obesity be recognized as a disease?
With obesity now affecting almost a third (29%) of the population in England, and expected to rise to 35% by 2030, should we now recognize it as a disease?

Is obesity associated with risk of pediatric MS?
A single-center study of 453 children in Germany with multiple sclerosis (MS) investigated the association of obesity with pediatric MS risk and with the response of first-line therapy in children with MS.

Women with obesity prior to conception are more likely to have children with obesity
A systematic review and meta-analysis identified significantly increased odds of child obesity when mothers have obesity before conception, according to a study published June 11, 2019 in the open-access journal PLOS Medicine by Nicola Heslehurst of Newcastle University in the UK, and colleagues.

Obesity medicine association announces major updates to its adult obesity algorithm
The Obesity Medicine Association (OMA) announced the immediate availability of the 2019 OMA Adult Obesity Algorithm, with new information for clinicians including the relationship between Obesity and Cardiovascular Disease, Diabetes Mellitus, Dyslipidemia, and Cancer; information on investigational Anti-Obesity Pharmacotherapy; treatments for Lipodystrophy; and Pharmacokinetics and Obesity.

Read More: Obesity News and Obesity 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.