ACMOMS 2008

ASIAN CONSENSUS MEETING ON METABOLIC SURGERY
August 8 and 9, 2008 Trivandrum, Kerala 52 participants.

As obesity and type 2 diabetes have reached epidemic levels in Asia, we have gradually realized that the western diagnostic criterion for obesity and metabolic syndrome do not hold true for the Asian population.

Asians tend to develop diabetes with a lesser degree of obesity at younger ages, suffer longer with complications of diabetes and hence die sooner than people in other regions.

The first Asian consensus meeting was organized to review the scientific data relevant to specific geographical populations. The existing guidelines for bariatric surgery in the Asian population were reviewed with the goals:
  1. To set culturally, geographically, and genetically relevant standards for the management of obesity and metabolic syndrome.
  2. To identify the usefulness of BMI as a principal criteria for identification of obesity in the Asian population.
  3. To identify waist circumference or waist–hip ratio as additional criteria for defining obesity in the Asian population.
  4. To set parameters to identify visceral or central obesity versus truncal obesity.
  5. To develop recommendations for development of ethical clinical studies for antidiabetes surgery.
Following a series of presentations by eminent speakers, the members voted for a renewed set of guidelines and recommendations defining the BMI criterion in the Asian population.

Guidelines:
  1. Bariatric/gastrointestinal metabolic surgery should be considered as a treatment option for obesity in people with Asian ethnicity with BMI more than 35 kg/m2 with or without comorbidities.
  2. Bariatric/gastrointestinal metabolic surgery should be considered as a treatment option for obesity in people with Asian ethnicity above a BMI of 32 kg/m2 with comorbidities.
  3. Bariatric/gastrointestinal metabolic surgery should be considered as a treatment option for obesity in people with Asian ethnicity above a BMI of 30 kg/m2 if they have central obesity (waist circumference more than 80 cm in females and more than 90 cm in males) along with at least two of the additional criteria for metabolic syndrome: raised triglycerides, reduced HDL cholesterol levels, high blood pressure and raised fasting plasma glucose levels.
  4. Any surgery done on diabetic patients with a BMI less than 30 kg/m2 should be strictly done only under study protocol with an informed consent from the patient. The nature of these surgeries should be considered as yet purely experimental only as part of research projects with prior approval of the ethics committee.

The consensus statement was published in the Obesity Surgery Journal. Please find the link below: http://www.bmihk.info/download/Consensus.pdf