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).
References
Page Review Information
Review date 06 January 2026
Next review date 06 January 2028
GP Speciality lead Dr Melanie Schick
Contributors Dr Steven Creely, Consultant RCHT,
Dr Duncan Browne Consultant RCHT,
Deputy programme of care lead, Long term conditions