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Weight Loss Surgery More Effective Than Diet

But Risks of Obesity Surgery Are Serious and Real

What if You're Obese, but Not Morbidly Obese?

If surgery gets such good results, why not recommend it for appropriate patients who aren't yet morbidly obese? Snow says the evidence just isn't there.

"We did not feel the evidence was strong enough to recommend surgery in the group of patients with a BMI of 35-40 and [obesity-related health problems]," she says. "We just felt this is not an emergency for these patients. Given that this is an elective surgery, with very real risks, we felt that the benefits for this patient group were not clear enough. We felt patients with BMIs over 40 were likely to receive more benefit."

Snow, of course, is talking about official guidelines based on evidence from clinical trials. Khaitan says doctors may very well consider weight loss surgery for some patients whose BMI has not yet reached 40.

"The operation is a big deal. It is not something to take lightly," she says. "For someone with a BMI below 35, it is hard to justify a big operation for that degree of weight loss. But if someone has a BMI of 35 to 40 and obesity-related medical problems, it is still reasonable to seek surgical treatment."

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