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Report: Asian Consensus Meeting on Metabolic Surgery. Recommendations for the use of Bariatric and Gastrointestinal Metabolic Surgery for Treatment of Obesity and Type II Diabetes Mellitus in the Asian Population

August 9th and 10th, 2008, Trivandrum, India

Abstract

Background

The report submitted is a detailed analysis of the happenings and outcomes of a two day deliberation that was organized in Trivandrum, India on the 9th and 10th August 2009.

Methods

Asian Consensus Meeting on Metabolic Surgery (ACMOMS) was the first ever meeting of its kind in Asia where 52 professionals involved in the field of bariatric surgery, metabolic surgery, diabetes, and medical research from countries across Asia and the GCC met at Trivandrum, India to vote for and create a new set of guidelines for the Asian genotype, which were different from the NIH guidelines set for bariatric surgery. The aim was to set culturally, geographically, and genetically relevant standards for the management of obesity and metabolic syndrome.

Results

It is known that Asians have a higher adiposity for a given level of obesity, and this is visceral obesity as compared to other populations. Currently, all over the world and in Asia as well, guidelines set by NIH in 1991 are being followed. Surgeons believe that NIH guidelines need to be revisited and modified. It is in light of these observations that the genesis of ACMOMS took place. At ACMOMS, it was recommended that the NIH guidelines are not suitable for Asians, and the BMI guidelines should be lowered for indication of surgery. Waist or waist–hip ratio must gain significance as compared to BMI alone in Asia.

Conclusions

The collective recommendations were submitted as a report to the executive committee for approval. As the Asia Pacific region consists of more than half of the world's population, the dire health and economic consequences of this epidemic demand urgent action from the medical fraternity in this region, and we hope that the recommendations will help to review the currently accepted guidelines.

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Author information

Correspondence to Muffazal Lakdawala.

Appendix

Appendix

Executive Committee Members

Chair: Dr. Bansi Saboo, Endocrinologist, Hon Secretary RSSDI, Gujarat, India; Dr. Harry Frydenberg, Bariatric Surgeon, Epsworth Training Center, President: International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO), Melbourne, Australia; Dr. John Dixon, Head of Clinical Research, Centre for Obesity Research and Education and Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Dr. M. A. Lakdawala, Bariatric Surgeon, Chief: Department of Minimal Access Surgery, Saifee Hospital, Mumbai, Founder, Centre of Obesity & Diabetes Support, Vice President: Obesity and Metabolic Surgery Society of India [OSSI], Mumbai, India; Dr. Pradeep Chowbey, Bariatric Surgeon, President Elect: IFSO APC, Governor, Society of Endoscopic and Laparoscopic Surgeons of Asia (ELSA), Chairman, Minimal access, Metabolic and Bariatric Surgery Centre, Sir Gangaram Hospital, New Delhi, India; Dr. Rolf Hartung, Consultant Surgeon, Head of General Surgery, Dubai Hospital, Government of Dubai and Associate Professor of Surgery, Dubai Medical College, Dubai; Dr. S. Bandukwala, Physician, Saifee Hospital, Lilavati Hospital, Mumbai, India; Dr. S. Joshi, Endocrinologist; Lilavati Hospital, Vice President RSSDI, President Elect AAIRO, Mumbai, India; Dr. W.J. Lee, Bariatric Surgeon, President: Asia Pacific Bariatric Surgery Society (APBSS), Director, Asia Pacific Endoscopy Bariatric Surgical Center, Professor of Surgery, National Taiwan University, Chairman, Asia Pacific Bariatric Surgical Group, President, Taiwan Association for Endoscopic Surgery, Taiwan.

Speakers at the Summit

Organizer and Convenor: Dr. M. A. Lakdawala, Bariatric Surgeon, Chief: Department of Minimal Access Surgery, Saifee Hospital, Mumbai, Founder, Centre of Obesity & Diabetes Support, Vice President: Obesity and Metabolic Surgery Society of India [OSSI], Mumbai, India.

Co-Convenor: Dr. Pradeep Chowbey, Bariatric Surgeon, President Elect: IFSO APC, Governor, Society of Endoscopic and Laparoscopic Surgeons of Asia [ELSA], Chairman, Minimal access, Metabolic and Bariatric Surgery Centre, Sir Gangaram Hospital, New Delhi, India

Keynote speakers: All the members of the executive committee were speakers at the summit. Dr. Ashok Damodaran, MS, DNB, Pakar Perunding Bedah, Hospital Sebu, Malaysia; Dr. Anton Cheng, FRCS (Ed), FRACS, Senior Consultant, Department of surgery, Alexandra Hospital, Singapore; Dr. Hildegardes C. Dineros, Bariatric and metabolic surgeon, Healing hand clinic and St. Luke’s Medical center, Philippines; Dr. Prashant Mathur, DCH, DNB, PhD, MNAMS, Assistant Director General, Division of non communicable diseases, Indian council of medical research, New Delhi, India; Dr. Faruq Badiuddin, MS, FRCS, Consultant Surgeon, Wellness medical center, Rosary medical center, Village medicenter, Dubai; Dr. Wilfred Lik Man Mui,MBChB, FRCS (Ed), FRACS, Union Hospital, Hongkong; Dr. Chih-Kun Huang, Chief- International Endoscopic Obesity Center, E-Da Hospital and I- Shou University, Taiwan; Dr. Sang Moon Han, MD, Assistant Professor, Department of surgery, College of medicine, Pochon, CHA University-CHA General Hospital, Korea; Prof. Paisal Pongchairerks, MD, FICS, FRCS,Thai board of general Surgery, Thailand; Dr. Mahendra Narwaria, MS, Asian institute of gastroenterology surgery, President- Obesity and metabolic surgery society of India; Dr. Ramen Goel, MS, Wockhardt hospital and Bombay hospital, India; Dr. Surendra Ugale, MS, Kirloskar hospital, Hyderabad, India; Dr. S. Sheikh, MD, Consultant endocrinologist, Saifee hospital, Mumbai, India; Dr. S. Goel, MD, Consultant anesthetist, Saifee Hospital, Center for Obesity and Diabetes Support, Mumbai, India.

Summit Organizing Committee

Dr. Yasin Kazi, MS, Consultant surgeon, Center for Obesity and Diabetes Support, Mumbai, India; Dr. Aparna Govil Bhasker, Consultant surgeon, Center for Obesity and Diabetes Support, Mumbai, India; Payal Batra, Consultant nutritionist, Center for Obesity and Diabetes Support, Mumbai, India; Sneha Jain, Consultant nutritionist, Center for Obesity and Diabetes Support, Mumbai, India.

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Lakdawala, M., Bhasker, A. Report: Asian Consensus Meeting on Metabolic Surgery. Recommendations for the use of Bariatric and Gastrointestinal Metabolic Surgery for Treatment of Obesity and Type II Diabetes Mellitus in the Asian Population. OBES SURG 20, 929–936 (2010). https://doi.org/10.1007/s11695-010-0162-7

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Keywords

  • Bariatric surgery
  • Gastrointestinal metabolic surgery
  • Body mass index
  • Central obesity
  • Waist hip ratio
  • Type 2 diabetes
  • Body fat percentage
  • Thrifty gene
  • Laparoscopic roux-en-y gastric bypass
  • Laparoscopic sleeve gastrectomy
  • Laparoscopic adjustable gastric banding
  • Consensus