Surgical Obesity Treatment – Necessity or an Easy Way to Lose Weight?

The determination of eligibility for bariatric surgery is founded upon a comprehensive clinical assessment that incorporates multiple factors, including the patient’s biological age, peak recorded body mass index (BMI), and the presence of obesity-related comorbidities. Typically, this surgical intervention is recommended for adult patients aged 18–65 years whose BMI reaches or exceeds 40 kg/m². For individuals with a BMI ranging from 35.0 to 39.9 kg/m², the procedure may be considered if there is substantiated medical evidence suggesting that surgical weight reduction will yield significant health improvements—particularly in cases complicated by concurrent conditions such as insulin-resistant type 2 diabetes mellitus, cardiovascular disorders (e.g., hypertension, atherosclerosis), or obstructive sleep apnea syndrome. In exceptional circumstances, patients with a BMI of 30.0–34.9 kg/m² may qualify for surgery if hyperglycemia remains refractory to conventional pharmacological treatments and the risk of metabolic complications is substantial. For minors under the age of 18, bariatric surgery is contemplated only after the patient has attained sufficient physical and psychological maturity, coupled with the exhaustion of all conservative treatment modalities (dietary modification, physical activity, behavioral therapy) over a minimum duration of six months. In patients older than 65 years, bariatric procedures are primarily reserved for cases of morbid obesity (BMI > 40 kg/m²), provided that the anticipated health benefits substantially outweigh the operative risks and the patient’s overall health status—including biological age—does not pose a contraindication (as outlined in the guidelines of the Polish Society for Bariatric Surgery, Budzyński et al., 2017).