BMI isn't the main factor in choosing the right weight loss operation

Researchers find patients and doctors are using other factors like having type-2 diabetes, eating habits and risk aversion to a particular kind of surgery in order to make an informed decision.
Posted By Ananth Baliga  |  Nov. 22, 2013 at 11:36 AM
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Nov. 22 (UPI) -- A new study has found that a patient's body mass index or the measure of their obesity isn't the compelling factor in determining the appropriate weight loss operation for them.

Researchers found that the determining factors used to make this decision were whether the patient had type-2 diabetes, how much weight they wanted to lose and their tolerance to surgery. This, researchers said, was a good trend because it meant that patients were talking to their surgeons and choosing the best option based on a holistic assessment of the situation.

"BMI alone was not an important determinant, suggesting that patients and their surgeons considered the whole patient and what was important to him or her," according to principal investigator Christine Wee of Harvard Medical School.

However, lead author Caroline Apovian said that people who had issues with uncontrolled eating were choosing laparoscopic banding rather than the more appropriate gastric bypass surgery.

This, she said, could be because laparoscopic banding was reversible and gastric bypass is typically not.

Laparoscopic banding involves placing a band around the stomach and the band can be adjusted to allow more or less food intake. But in a gastric bypass surgery a part of the stomach is removed, rerouting most of the food, bypassing the stomach and ensuring fewer calories are absorbed.

The study found that patients who exhibited higher levels of uncontrolled eating were more likely to have type 2 diabetes, poorer quality of life, a higher weight loss goal, and greater tolerance for assuming risk and chose to go in for a gastric bypass. While those who chose laparoscopic banding had lower body mass index, patients had similar risk preferences and eating behavior as those who had a gastric bypass.

Dr. Wee said the study results suggest that behavioral characteristics and patient preferences may be as, or more, influential than BMI in the decision-making process.

The study is published in the December issue of the Journal of the American College of Surgeons.

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