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March 23, 1979

Surgical Treatment of Morbid Obesity

JAMA. 1979;241(12):1271. doi:10.1001/jama.1979.03290380047029

The consensus reached at the National Institutes of Health Consensus Development Conference on surgical treatment of morbid obesity recently held in Bethesda, Md, was that surgical intervention in morbid obesity should be confined to persons who suffer from physical or emotional complications where medical methods have previously failed. Morbid obesity was defined by participants as 45 kg overweight or 200% or more of desirable weight, according to Metropolitan Life Insurance Company standards. While conferees agreed that conventional treatments of dieting and fasting are ineffective for most sufferers, they disagreed on preferred surgical technique for the condition.

The two most common surgical procedures for overweight are jejunoileal intestine bypass and gastric bypass. The former is more established and contributes to greater weight loss, but it also involves more complications, such as severe diarrhea, flatulence, liver failure, arthritis, and possibly cancer of the colon, noted University of Minnesota surgeon Henry Buckwald, MD.