Tell it Like it T-I-S

Sometimes it pays to be direct.

Literally.

On a similar note, here's another musical reference in regards to the title of this post for those interested in an 80s challenge.

Check your guess at the band and the song at the link that follows: http://www.youtube.com/watch?v=OhLByM96XRg



So, why all the fuss?

I just saw in a recent issue of Medline Surgery, an article entited "New Bariatric Surgery Guidelines Reflect Rapidly Evolving Field."

The article went on to describe updated clinical practice guidelines for bariatric surgery refelective of its therapeutic potential for patients with lower body weight who have cardiometabolic risk factors.  Also included were affirmations that Sleeve Gastrectomy is an equally acceptable option with similar weight and metabolic benefits.

Sound at all familiar?  (Just telling it like it T-I-S)

The guidelines were developed by a 12-member panel, and issued jointly by the American Association of Clinical Endocrinologists, The Obesity Society, and the ASMBS (American Society for Metabolic & Bariatric Surgery).  They were published online March 25 in the journals of those 3 organizations.

Not only did they recommend surgery at a lower BMI for those at most risk, but also included peroperative nutritional and non-surgical perioperative support for surgical weight loss patients, aimed at keeping pace with the latest available evidence in the field.

The current version of those who should be advised surgery includes those with BMI > 40, or those with significant comorbid conditions and a BMI of 35 or higher.  This update added that those with a BMI of 30 - 34.9 and Diabetes or metabolic syndrome "be offered a bariatric procedure, although the current evidence is limited."

The first intent of the surgeries is obviously to lose weight, but as time and experience shows consistent efficacy against metabolic disease, and the mechanisms of those disease states are further delineated, bariatric surgery deserves to be in the mix of targeted therapeutic options that can be of benefit across the spectrum of that disease state.

And, as this article, the newest clinical practice guidelines, and experience continues to show, Earlier is Better - both in terms of BMI as well as duration and severity of Diabetes, in order to get the biggest bang for your surgical buck!

Now the next part of this equation is consensus along the insurance spectrum as far as reimbursement for these procedures against that comorbidity backdrop.  That will likely take a while,  but the latest disclosed information is a few steps in the right direction.