Bariatric Surgery
This guidance applies to those aged 18 years and over
Referral Criteria
-
The patient has a BMI of 50kgs/m2 or more, surgery should be considered as a first line treatment intervention.
- The patient has a BMI of 40kgs/m2 or more, or a BMI of 35-40kgs/m2 plus other obesity-related complications that could be improved with weight loss.
Examples include:
- Type 2 diabetes
- Cardiovascular disease
- Hypercholesterolaemia on treatment
- obstructive sleep apnoea
- non-alcoholic fatty liver disease with or without steatohepatitis
- hypertension (including idiopathic intracranial hypertension)
- osteoarthritis of weight bearing joints
AND
The patient agrees to the necessary long-term follow up after surgery (for example, lifelong annual reviews).
Consider referral for people of South Asian, Chinese, other Asian, Middle Eastern, Black African or African–Caribbean background using a lower BMI threshold (reduced by 2.5 kg/m2), to account for the fact that these groups are prone to central adiposity and their cardiometabolic risk occurs at lower BMI.
Expedited assessment
Offer an expedited assessment for bariatric surgery to people:
with a BMI of 35 kg/m2 or more who have been diagnosed with type 2 diabetes within the past 10 years AND they are also receiving, or will receive, assessment in a specialist overweight and obesity management service.
Consider an expedited assessment for bariatric surgery for people:
with a BMI of 30 to 34.9 kg/m2 who have been diagnosed with type 2 diabetes within the past 10 years AND they are also receiving, or will receive, assessment in a specialist overweight and obesity management service.
Consider an expedited assessment for bariatric surgery for people of South Asian, Chinese, other Asian, Middle Eastern, Black African or African–Caribbean background using a lower BMI threshold (reduced by 2.5 kg/m2).
Referrals for GLP1 injections for weight loss
From 20/12/24 new referrals to the weight loss service for GLP-1 agonists are being paused until further notice.
Patients who have started their treatment will continue to receive their prescriptions.
Local support and digital support for helping people to manage their weight and be more active is still available via Healthy Cornwall at https://www.healthycornwall.org.uk/make-a-change/healthy-eating-getting-active-healthy-weight/adults-weight-management-and-physical-activity/
National programmes are also available via https://www.nhs.uk/better-health/ and NHS England » The NHS Digital Weight Management Programme.
References
Page Review Information
Review date 09 May 2025 (Partial update)
Next review date 09 May 2026
GP Speciality lead Dr Melanie Schick
Contributors Deputy programme of care lead, Long term conditions