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Bariatric surgery: Eligibility criteria (East Lancs PCT)

As per contract with East Lancs PCT (as of Dec 2009)
If all of the following fulfilled:
  • All intensive efforts of non-invasive weight reduction have failed.
  • Usually longer-standing obesity (eg > 5 years).
  • Either:
    • BMI >= 50 kg/m²; or
      • (1) BMI >= 45 kg/m² (vs. NICE: 40)
      • (2) comorbidities a/w obesity:
        • T2DM (esp if severe, uncontrolled)
        • OSA (severe)
        • Obesity hypoventilation syndrome
        • Obesity related pulmonary hypertension
        • Obesity-related cardiomyopathy
        • Hypertension (clinically unmanageable)
        • Established Coronary Heart Disease (eg MI in past 6 mths)
        • TIA / stroke (if good functional recovery) within past 6 mths
        • others: eg Pickwickian syndrome (on individual patient basis)
  • failure of maintaining significant weight loss (>=10%) despite having completed and complied with specialist wt managemt programme in specialised obesity clinic or with Specialist Dietician for >= 6 mths within the last 12 mths
  • age >= 18
  • failure of appropriate non-surgical measures including pharmacotherapy for 6mth within last 12 mths
  • no specific clinical/psychological contraindications (eg Eating disorder)
  • patient is generally fit for anaesthesia and surgery
  • patient is committed to need for FU by a doctor, and long-term compliance with altered lifestyle and dietary habit postop
  • realistic expectations of surgery outcome (max. weight loss occurs 1-2 yrs after surgery), cosmetic plastic procedures to remove excess skin at discretion of PCT


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