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The 2022 guidelines for obesity surgery are here, based on rigorous, transparent evidence reviews, unlike the 1991 panel. This new process involved 24 international experts, primarily bariatric surgeons, using the PRISMA methodology for systematic reviews. Most topics were supported by hundreds of studies, with a Delphi survey used for areas lacking literature. This ensures guidelines reflect current evidence and practice.

Less than 1% of eligible patients get bariatric surgery. If you've been told you don't qualify, ask by whose criteria. Insurance guidelines may not reflect current medical evidence or expert recommendations. Advocate for yourself, get a second opinion, and understand the real guidelines. Obesity is a chronic disease, not a willpower failure.

BMI can't distinguish between muscle and fat, or where fat is stored. Visceral fat around organs is a major health risk, driving metabolic diseases, while subcutaneous fat might even be protective.

Did you know that only 0.5-1% of eligible patients receive bariatric surgery? This healthcare system is failing. In Florida, just 11% with insurance have coverage. This is a massive problem.

Significant changes in 2023: The American Academy of Pediatrics now recommends bariatric surgery evaluations for adolescents 13+ with severe obesity. This guideline, backed by Grade A evidence, offers hope, but insurance policies often lag behind.

Decades of research show metabolic and bariatric surgery is safe and effective. New guidelines lower BMI thresholds, include Asian populations with lower thresholds, and now include adolescents and the elderly. Endorsed procedures now focus on bypass and sleeve gastrectomy.

It's not a failure of willpower or character, it's a disease. Bariatric surgery is one of the most effective treatments available. The evidence is overwhelming and procedures have become safer with better outcomes.

The right bariatric procedure is chosen through shared decision making. I evaluate your biology, risks, and long term goals, and we choose the safest, most effective operation together.

Real science. Real surgery. Real results.

Duodenal Switch  patients often eat more long‑term than gastric bypass patients and still lose more weight. The longer bypass and controlled malabsorption create a unique metabolic advantage that goes far beyond restriction.
duodenalswitch

SADI/DS carries a higher risk of vitamin deficiencies than gastric bypass. It’s not ideal for patients who cannot maintain long‑term supplementation or who have conditions that worsen malabsorption.
SADI