Updated Criteria
The ASMBS/IFSO 2022 joint statement indicates surgery at BMI 35 and above regardless of comorbidities. At BMI 30–34.9, surgery may be considered in patients with uncontrolled type 2 diabetes or severe metabolic disease.
Factors Considered
Duration and severity of type 2 diabetes
Presence of hypertension, dyslipidaemia
Non-alcoholic fatty liver disease / NASH
Severe obstructive sleep apnoea
Quality of life impairment from joint pain
Response to prior treatment attempts
Decision Process
BMI alone is insufficient. Waist circumference, body composition, comorbidity control, patient motivation, and prior therapy responses are evaluated together.
Criteria Define Who Can Be Evaluated, Not Who Will Have Surgery
The ASMBS/IFSO 2022 criteria are not a checklist that determines who “will” have surgery; they define who may be considered for evaluation. Meeting the BMI threshold is not, by itself, an indication for surgery.
A multidisciplinary assessment may just as reasonably conclude that a non-surgical path — lifestyle support, obesity medication, or continued monitoring — is the right course. The decision is made individually, alongside examination findings, comorbidities, and patient preference.
Important Caveat
Surgery at lower BMI is not a cosmetic procedure. Use outside recognised indications does not meet regulatory standards. The decision is individual and follows multidisciplinary evaluation.
References
This content is for general information only; it does not replace an examination, diagnosis or treatment.
Medical notice: The information on this page is for general patient education only and does not replace medical diagnosis, treatment, or a surgical decision. The appropriate method for you can only be determined after a physician's assessment and necessary tests.
Medical content editor: Op. Dr. Gökhan Ateş — Specialist in General Surgery
Last updated: · Patient information content
Site editor: atesdr@yahoo.com — Please do not send test results, reports, photographs or sensitive health data to this address.