While bariatric surgery is appropriate for a wide range of patients with obesity, certain conditions require careful evaluation or make surgery inappropriate:
Uncontrolled psychiatric conditions active psychosis, severe untreated depression, or eating disorders such as binge eating disorder that have not been formally assessed and addressed
Active substance misuse alcohol or drug dependence requires treatment and a period of sustained recovery before surgery is considered
Medical conditions that make general anaesthesia excessively high risk assessed individually by the anaesthetic team
Inability to commit to lifelong nutritional supplementation and dietary change bariatric surgery requires permanent behavioural change and is not appropriate for patients unable or unwilling to make this commitment
Pregnancy or intention to become pregnant within two years specific counselling is provided as bariatric surgery significantly affects pregnancy planning
Age alone is rarely an absolute contraindication. I assess older patients individually based on functional status and likely benefit. Every patient undergoes a multi-disciplinary assessment before surgery is recommended.
Written by Dr Niranjan P, MBBS (Rajiv Gandhi University of Health Sciences, Karnataka), DNB General Surgery (National Board of Examinations, New Delhi), Consultant General, GI, Laparoscopic, Robotic and Bariatric Surgeon, NiSH Clinic, 48, 7th B Main Rd, 4th Block, Jayanagar, Bengaluru 560011.
