Criteria 1
BMI > 40 (or appropriate ethnic adjustment — see note 1 below)
AND
b) Type 2 diabetes with
AND
c) either one of the following
- Inadequate Control (HBA1c >64mmol/mol) on maximal oral therapy
- Presence of nephropathy (eGFR <45 OR Albumin:Creatinine ratio >10mg/mmol)
- Metabolic dysfunction associated Steatohepatitis (MASH - aka as NASH)
- Onset of diabetes under the age of 40yrs old
- Insulin resistance (>2units/kg/day)
Criteria 2
a) Patient with BMI >35 kg/m2 (or appropriate ethnic adjustment — see note 1 below)
AND
b) Requiring time-sensitive surgery/procedure:
e.g. Organ transplant, arthroplasty because of immobility, spinal surgery, cardiac surgery, cancer surgery, limb or sight saving surgery, abdominal wall hernia repair, fertility treatment
(N.B. this list is not restrictive and subject to discretion of MDT team)
Please specify and supply supporting documentation.
Criteria 3
a) BMI >40 kg/m2 (or appropriate ethnic adjustment — see note 1 below)
AND
b) at least two of the following significant comorbidities:
- BMI >50 kg/m2
- Sleep apnoea requiring CPAP
- Systolic or diastolic cardiac dysfunction (i.e. Heart failure)
- Resistant hypertension (3 or more blood pressure tablets)
- Idiopathic intracranial hypertension
- Metabolic dysfunction associated Steatohepatitis (MASH - aka as NASH)
- Atrial fibrillation
Criteria 4
Any rare or monogenic condition where bariatric surgery or drug intervention has been shown to provide significant clinical benefit. NB. these will be assessed on an individual basis.
Please specify and provide supporting documentation.
Note 1
People with a South Asian, Chinese, other Asian, Middle Eastern, Black African, or African-Caribbean family background please lower BMI thresholds by 2.5 kg/m2.
