Eligibility Criteria for Sleeve Gastrectomy

Global obesity is rising at an alarming rate, with estimates predicting that by 2030 nearly 1 in 2 adults will have obesity (BMI ≥ 30 kg/m2), and 1 in 4 adults will have severe obesity (BMI ≥ 35 kg/m2). With this increasing number of patients with severe obesity and related comorbidities, there has been an increasing role for bariatric surgery in managing these conditions. The most striking upsurge was seen in the number of sleeve gastrectomies (SG) performed, rising from 17.8% of total procedures performed in 2011 to 61.4% of total procedures performed in 2018. This increasing popularity of SG over the past decade has been due to its safety profile, technical ease, and excellent long-term efficacy. However, a blanket prescription of this procedure should be avoided, and an effort towards more personalized and evidence-based procedure selection should be adopted. In this chapter, we will first explore the current indications for metabolic and bariatric surgery, followed by a criterion that makes SG a better surgical option.