BMI criteria for obesity surgery should be lowered, UT Southwestern researcher suggest

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BMI criteria for obesity surgery should be lowered, UT Southwestern

researcher suggest

Media Contact: Holland Shear

kristen.hollandshear@...

DALLAS - Dec. 18, 2007 - UT Southwestern Medical Center researchers have

found that the existing body mass index criteria for obesity surgery

often excludes a group of obese patients at risk of cardiovascular disease.

The study, appearing in the December issue of the journal Surgery for

Obesity and Related Diseases, is among the first to evaluate the

risk-factor relationship between body mass index (BMI) and

cardiovascular disease as it relates to bariatric surgery criteria, said

Dr. Livingston, chairman of GI/endocrine surgery at UT

Southwestern and lead author of the study.

" Our results show that cardiovascular risk factors do not necessarily

worsen with increasing obesity, " Dr. Livingston said. " They also support

the concept that obesity, by itself, doesn't trigger an adverse

cardiovascular risk profile or increased risk of death. "

The researchers examined patient data from the Third National Health and

Nutrition Examination Survey database for the presence of known

cardiovascular risk factors as a function of obesity. The survey was a

cross-sectional study conducted from 1988 to 1994. All 17,234

participants had a BMI greater than 20.

BMI is a weight-to-height ratio commonly used in doctors' offices to

gauge obesity. A normal BMI is between 18.5 and 25, whereas someone with

a BMI of 40 or more is at least 100 pounds over their recommended weight

and is considered morbidly obese.

Bariatric weight-loss surgery is currently recommended for patients with

a BMI greater than 40, as well as for patients with a BMI greater than

35 who also suffer from a life-threatening illness, such as non-insulin

dependent diabetes, sleep apnea or heart disease.

The study findings show that some morbidly obese patients have better

cardiovascular disease risk profiles than those who are less obese. In

particular, the researchers found that cardiovascular risk factors can

be much worse in many individuals with a BMI as low as 30 than they are

for some surgical candidates with higher BMIs.

This suggests that some patients who are obese but not morbidly obese

could benefit from bariatric surgery, which can help reduce

cardiovascular disease, said Dr. Livingston.

Dr. Nicola Abate, associate professor of internal medicine in the Center

for Human Nutrition at UT Southwestern and the study's co-author, said

it's possible that very obese patients simply have a greater capacity to

store excessive calories in their adipocytes, or fat cells, thereby

preventing excessive fat from spilling into the bloodstream, where it

contributes to heart disease.

" Our findings suggest that there is a group of individuals who have an

almost unlimited ability to store excess calories as fat. This prevents

changes in plasma metabolites, such as triglycerides and cholesterol,

which promote risk for heart disease, " Dr. Abate said. " In contrast,

those who can't store as much fat and who only accumulate fat in the

upper body often have excessive plasma concentrations of triglycerides

and cholesterol, which will increase their risk for heart disease. Even

though their BMI may be below the current recommended cutoff, these

patients could potentially benefit from bariatric surgery. "

Dr. Manisha Chandalia, associate professor of internal medicine in the

Center for Human Nutrition, co-authored the study.

Visit

http://www.utsouthwestern.org/patientcare/medicalservices/bariatrics.html

to learn more about UT Southwestern's clinical services in bariatrics.

###

This news release is available on our World Wide Web home page at

http://www.utsouthwestern.edu/home/news/index.html

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