From the Guidelines
Patients with a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health conditions, should be considered for laparoscopic adjustable gastric band (LAGB) surgery. According to the American Gastroenterological Association medical position statement on obesity 1, surgical therapy is the most effective approach for achieving long-term weight loss in these patients. The statement specifies that patients with class III obesity (BMI ≥ 40 kg/m2) or class II obesity (BMI 35.0 –39.9 kg/m2) with one or more severe obesity-related medical complications should be considered for surgery if they have been unable to achieve or maintain weight loss with conventional therapy.
Key considerations for LAGB surgery include:
- BMI thresholds: 40 or higher, or 35 or higher with obesity-related health conditions
- Obesity-related health conditions: hypertension, type 2 diabetes mellitus, heart failure, or sleep apnea
- Failed weight loss attempts through diet and exercise programs
- Comprehensive medical evaluations: psychological assessment, nutritional counseling, and various lab tests
The benefits of surgical intervention, including LAGB surgery, outweigh the risks at these obesity levels, as severe obesity significantly increases mortality and morbidity from numerous conditions, including cardiovascular disease, diabetes, and certain cancers 1. Therefore, LAGB surgery should be considered for patients who meet the specified BMI criteria and have undergone comprehensive medical evaluations.