IFSO-Statement

I.F.S.O.

(INTERNATIONAL FEDERATION FOR THE SURGERY OF OBESITY)

STATEMENT ON MORBID OBESITY AND ITS TREATMENT

Morbid obesity is a chronic, lifelong, multifactorial, genetically-related disease of excessive fat storage with highly significant medical, psychological, social, physical and economic co-morbidities. As such, it also involves hereditary, biochemical, hormonal, environmental, behavioral, public health and cultural elements.

Morbid obesity is, therefore, an extreme health hazard which is rarely the result of an aberrant moral problem or addictive behavior. There is an extremely high incidence of failure to sustain even a 10 per cent long-term weight loss in morbidly obese patients with any form of non-operative treatment.

Bariatric surgery, on the other hand, has been shown to be the most effective means to aid in management and prophylaxis of the life-threatening complications and severe degenerative problems of morbid obesity. It is indicated due to the ineffectiveness of non-operative treatment methods for morbid obesity, the high risk of untreated morbid obesity, and the safety and effectiveness of operative treatment. Safe, effective bariatric operative procedures increase the longevity and quality of life in morbidly obese patients. Such surgery is performed as treatment for the co-morbidities of morbid obesity. Weight loss, while an essential component of this process, is only incidental to these goals, as is any possible cosmetic outcome.

Patients with sleep apnea, obesity hypoventilation, cardiac failure, or other life-threatening complications may require emergency admission and care. An operation can then be planned at a time when the patient`s condition is stable with adequate cardiorespiratory reserve.

Size discrimination condemns morbidly obese people to be excluded from access to medically necessary, quality care. Such discrimination and consequent exclusion is unacceptalbe. There is, therefore, no justification in requiring morbidly obese individuals to participate in long-term weight loss programs or requiring them to surmount comparable barriers as a prerequisite for approval of bariatric surgery, unless the surgeon`s judgement precludes same.