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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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