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The average age of the groups ranged from 43 to 51.

Those in group 1, with the lowest BMI, lost a greater percentage of excess weight at the one-year mark, shedding 167% of excess weight. Those in group 2 lost lost 112%, group 3, 85.3%, and group 4, 67.1%.There were no complications in group 1, Morton says.

Everyone in group 1 who had diabetes went into remission, and 72.7% to 74.6% of the others did.

''Bariatric surgery has become a lot safer," Morton says. "We wanted to look at it from the standpoint of outcome. In this new BMI group, the surgery can be done safely with superior results."

There were no complications in the low-BMI group, he says.

Bariatric surgery carries risks, such as vitamin and mineral deficiencies, gallstones, and death. The risk of death from bariatric surgery is about 0.1%, according to the American Society for Metabolic & Bariatric Surgery, citing research and government figures.

Bariatric Surgery: Perspective

Lowering the bar on bariatric surgery is not embraced by everyone. "I don't believe it is appropriate for people who are below a BMI of 35," says Jenn Berman, PsyD, a Beverly Hills, Calif., marriage and family therapist. She counsels patients with eating disorders and people who have had the surgery.

She has seen some patients ''out-eat'' the surgery, eating too much and undoing the benefits.

Eating disorders such as bulimia have to be addressed before the surgery, she says. "I believe that bariatric surgery is appropriate for people who are morbidly obese who have tried absolutely everything else and have been through extensive psychological screening to rule out eating disorders," she says.

However, Bruce Wolfe, MD, president of the American Society for Bariatric & Metabolic Surgery, takes another view. "What was remarkable in this trial was that the induction of remission of the diabetes was complete in all those [with the lowest BMI]," he says.

The study adds some valuable information about the surgery for a group that experts know little about, says Wolfe, a professor of surgery at Oregon Health & Science University in Portland.

This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.

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