Michael Schweitzer, M.D., F.A.C.S
The Johns Hopkins Obesity Surgery Center The Johns Hopkins University School of Medicine and Health Systems
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Information Criteria Consultation Forms You Will Need!! Resume Insurance The Diet After Surgery Directions Video Links Home Page	Criteria For Morbid Obesity Surgery In 1991, the National Institutes of Health (NIH) held a consensus conference (*) where health care professionals examined all aspects of morbid obesity. They were asked to make recommendations pertaining to its long-term treatment. They concluded that dietary management alone fail in the long run for the majority of patients who are morbidly obese. Patients who qualify for morbid obesity surgery should in general (patients need to be evaluated on an individual basis): 1. Their body mass index should be 40 kg/m^2 or higher. This is approximately 100 lbs. overweight. Patients may qualify if their BMI is between 35-40 and they have a significant morbid obesity related disease. 2. Patients should have tried dietary management regimes and failed for the long run (many patients lose weight on a diet only to regain it all back and then some). 3. Mental health disease is either absent or currently being treated, and also weight loss surgery is not contraindicated due to this disease. Patients must be willing to see a mental health professional after the operation even if they have never seen one before. 4. Patients should see their primary care physician to evaluate their medical conditions and decide if other tests or interventions are needed before morbid obesity surgery. (ex: heart and lungs) 5. Stop smoking for at least 1 month before surgery to decrease (not eliminate) its risks as they pertain to surgery and overall health. 6. Female patients must use extreme caution to prevent pregnancy for at least 1.5 years and then it should be done under physician guidance. 7. Patients must have a support system of friends or family to help them both physically and psychologically after the operation. 8. You and your support must realize that this is major abdominal surgery and this includes the risk of death. 9. You should be committed to healthy eating and exercise. You should realize that surgery is not a 100% easy cure and that it is an aid to help you lose weight. You must realize that supplements are for life and that medical follow-up with periodic lab testing is important. ****Gastrointestinal Surgery for Severe Obesity. NIH Consens Statement 1991 Mar 25-27;9(1):1-20. **** Body mass index >35 with a severe medical problem Body mass index > 40 (approximately 100 lbs over your ideal body weight) Body Mass Index Calculator - Female Body Mass Index Calculator - Gender Neutral List of Medical Diseases Associated with Obesity (only partial list) Coronary (heart) artery disease Congestive heart failure Hypertension (high blood pressure) Pulmonary embolism (blood clot to lung) Sleep apnea syndrome (snore and gasp for air at night) Obesity hypoventalation syndrome Pre-eclampsia Necrotizing pancreatitis Necrotizing soft tissue infections Adult-onset diabetes (type 2) Breast, endometrial, and colon cancer Unrecognized peritonitis (infection in the abdomen) Cirrhosis (liver disease) Degenerative osteoarthritis Urinary stress incontinence Gastroesophageal reflux disease (heartburn) Venous stasis ulcers Deep venous thrombosis (blood clots in you leg veins) Dyslipidemia (high cholesterol) Pseudotumor cerebri Hernia Dysmenorrhea (irregular periods, infertility) Nephrotic syndrome (kidney disease) Wound infections Depression Cholelithiasis (gallstones) This is only the beginning of who may qualify for surgery. An individual decision must be made at the time of consultation.
	Michael Schweitzer, M.D., F.A.C.S. Associate Professor of Surgery The Johns Hopkins University School of Medicine Director of Minimally Invasive Bariatric Surgery Johns Hopkins Bayview Medical Center Department of Surgery 4940 Eastern Avenue Baltimore, MD 21224 Phone: 410-550-3345 email DrSchweitzer@yahoo.com web site www.smallscar.com
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