Indications and contraindications
Authors: Anne Mosebo, Med. Stud., Mie Pilegaard Bjarnesen, Med. Stud. and Magnus Balslev Avnstorp, MD
Indications for massive weight loss surgery
The Danish scale for visual rating of massive weight loss (MWL) rates MWL by first, second and third degree. MWL of second (moderate) or third degree (severe) is a criterion for referral to a public hospital in Denmark along with the following criteria:
| Weight | A decrease in BMI of at least 15 points and a current BMI < 30kg/m2 (<34 for simple lipectomy) |
| Time | At least 6 months of weight stability after MWL At least 18 months after a potential bariatric surgery |
| Individually | Substantial psychosocial, functional and/or medical impairment from excess skin in daily life Physical: Pain, moisture, maceration, infection Impaired daily activity, reduced ability to work Psycosocial: Reduced quality of life, discomfort during activities, undressing, sexually |
| General health | ASA 1 or 2 |
| Appearance | Conspicuous and not age appropriate. It should not simply be a cosmetic and/or age-related issue |
Contraindications for massive weight loss surgery
| Absolute | Drug or alcohol abuse ASA > 3 Active psychosis (untreated psychiatric diagnosis) Smoking 6 weeks before and 3 weeks after surgery Metabolically unstable (GB blood samples), elevated risk of DVT or bleeding, diabetes mellitus |
| Relative | Continued obesity or excessive amount of subcutaneous fat tissue |