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News
Nearly 75% of bariatric surgery candidates meet criteria for "clinical obesity" — a new classification tied to organ dysfunction — and these patients face significantly higher surgical risks than BMI alone would suggest. A multicenter study found no meaningful BMI difference between clinical and preclinical obesity groups, underscoring why the new framework could reshape how surgeons select and prepare patients.
BMI has long been the gatekeeper for bariatric surgery eligibility — but a new study suggests it's leaving critical risk information on the table. Researchers applied the Lancet Diabetes and Endocrinology Commission's framework, which separates clinical obesity (excess adiposity with organ dysfunction) from preclinical obesity (excess adiposity without organ dysfunction), to over 2,300 bariatric surgery candidates across four countries.
The result? Nearly three-quarters of candidates qualified as clinically obese — and they carried a meaningfully heavier burden of disease, cardiovascular risk, and postoperative complications. Crucially, BMI levels were statistically similar between the two groups, confirming that BMI alone can't capture this risk.
By the Numbers:
Why it matters: This framework could fundamentally change how surgeons prioritize patients, plan anesthesia, and counsel on risk — moving beyond a single number toward a more nuanced, clinically meaningful assessment of who needs surgery most urgently.
