Reporting Results in Obesity Surgery: Evaluation of a Limited Survey

Background: Perhaps the most difficult problem in evaluating results of obesity surgery is the lack of standards for comparison, and the absence of consensus among professionals in definitions, classifications, and standard systems for reporting results, particularly in the analysis of successes and failures. Methods: Evaluation of the answers to a questionnaire submitted to 22 surgeons activity involved in the treatment of morbid obesity, members of the American Society for Bariatric Surgery. A total of 18 (82%) returned the survey. Results: There was consensus among the respondents for the need to use the metric system, Body Mass Index and measures for fat distribution. Patients should be divided into subgroups, according to gender, type of obesity, previous obesity surgery, those requiring reoperations, and when the original technique underwent modifications. The number and percentage of reoperations should be clearly stated, as well as the patients lost to follow-up, for each time period. The minimum long-term follow-up was considered to be 5 years. When expressing weight loss, percentage of excess weight lost and BMI were found to be most widely accepted. Quality of life measures and improvement of medical conditions are important in evaluating the results, although further discussion is necessary on these issues. There was lack of consensus in the best classification of obesity and super obesity, as well as in the definition of success and failure. Conclusions: This limited survey demonstrated general agreement in several important aspects amongst surgeons when analysing and reporting results. Further discussion is necessary in other significant issues, to reach uniformity in the assessment of outcomes in obesity surgery.