The new American College of Physicians' guidelines for obesity management
recommend diet and exercise for everyone.
Drugs and surgery are only recommended for obese patients who are not able to achieve weight-loss goals with diet and exercise alone.
The American College of Physician guidelines apply to patients with body mass indices over 30.
The guidelines state that patients with body mass indices over 30 might consider drug therapy.
|The estimated death rate from bariatric surgery range from 0.3 per 100 surgeries to as high as 2 per 100 surgeries|
|Annals of Internal Medicine|
Surgery is reserved for those with body mass indices over 40 who also have obesity-related health problems such as high blood pressure, diabetes, or sleep apnea.
The American College of Physician identifies 6 drugs that, according to valid clinical studies, aid weight loss, but says that the drugs have potential side effects and do not have long-term studies of effectiveness and safety.
Moreover, the average weight loss at one year is small to moderate.
The American College of Physician discusses several types of obesity or bariatric surgical procedures and cautions that none have randomized, controlled trials comparing surgery with non-surgical control groups.
Furthermore, all surgical procedures have possible side effects, ranging from surgical complications to gall bladder disease and digestive difficulties.
The American College of Physician guidelines estimate that the death rate from bariatric surgery, including in-hospital deaths and deaths within 30 days of discharge, range from 0.3 per 100 surgeries to as high as 2 per 100 surgeries.
The American College of Physician recommends, “Doctors and patients considering obesity surgery should seek highly experienced surgeons and surgical centers.”