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Clinically severe obesity is a multisystem disease that has been internationally recognized by the WHO for decades.

Through the accumulation of excess fat, it affects almost every organ in the human body and, beyond excess weight, establishes a systemic inflammatory condition while causing or aggravating pre-existing health problems such as increased blood pressure (hypertension), type II diabetes mellitus, dyslipidemia, respiratory disorders and cancer. In addition, its negative impact on everyday life is also reflected in simple daily activities, such as running, finding a suitable seat on an airplane, tying shoelaces or even crossing one’s legs, among others.

Obesity, like any disease, has its symptoms. Hunger is its most characteristic symptom. Treatment should not aim merely at managing the symptom, but at treating the disease itself, so that its symptoms consequently disappear as well.

Mapping the extent and severity of each patient’s obesity problem individually is a primary objective of the multidisciplinary and specialized team. This is carried out through a complete medical history to identify associated conditions, calculation of the relationship between weight and height, known as the Body Mass Index (BMI), and a series of blood tests, imaging examinations and clinical assessments by multiple specialties, extending beyond the physical condition to the patient’s psychological state and habits, with the aim of providing a holistic approach to the individual.

Dietary habits, the presence or absence of Metabolic Syndrome, the extent and complexity of its clinical presentation, the presence or absence of gastroesophageal reflux, and age are some of the key parameters used to determine the most appropriate procedure in Bariatric and Metabolic Surgery, where such surgery is required.

To understand the importance of these factors, it should be noted that 80% of morbidly obese patients are affected by Metabolic Syndrome, and in these cases a Metabolic Surgery approach should be adopted rather than a “simple” restrictive procedure, as such procedures are often promoted.

More specifically, assessment by specialized professionals is essential: a Bariatric Surgeon, Bariatric Anesthesiologist, Cardiologist, Pulmonologist, Endocrinologist, Gastroenterologist, Psychiatrist, Psychologist, Dietitian, as well as specialists in the preparation of bariatric patients, such as a Respiratory-Physical Status Performer, all of whom have received training in their respective fields in relation to morbid obesity and are therefore able to provide correspondingly specialized guidance based on selection or exclusion criteria established by International Scientific Organizations.

The International Federation for the Surgery of Obesity & Metabolic Disorders (IFSO), through its guidelines, has established the relevant criteria worldwide, most recently updated in October 2022.

It is the responsibility of the scientific community, once properly informed, to follow these guidelines in the treatment of the disease, and it is also the individual responsibility of those concerned to research the matter and consult professionals who have demonstrably specialized in the management of morbid obesity.

Certified professionals and centers of excellence, whether accredited by international or national bodies, represent the safest choice for patients seeking a solution to their health problem. Only in such settings are all necessary and standardized procedures implemented to ensure optimal treatment through invasive or non-invasive methods that are internationally accepted, effective and long-lasting, based on knowledge and without experimentation.

It is regrettable that, even in our country, there remains a persistent tendency among, fortunately, only a few, to adopt outdated or demonstrably ineffective methods.

The collaboration of the multidisciplinary team within a specialized and certified center guides the patient safely toward treatment of the disease. It is an unwavering responsibility to provide healthcare services based on scientific knowledge, with the least possible inconvenience to the patient, through established procedures and within the safe facilities of clinics or hospitals, so that the supreme value of health is served in the best possible way.

We are both pleased and proud to work for the benefit of patients with morbid obesity, in accordance with the rules, protocols and level of responsibility required.