Letter to the Editor: Weight Maintenance as an Indication for Metabolic and Bariatric Surgery

Obesity is recognised as a chronic, relapsing and progressive disease, and long-term weight maintenance remains one of the greatest challenges in obesity management. When treatment gets interrupted, recurrent weight gain might be expected. Funding structures for MBS in numerous health systems globally do not currently permit metabolic and bariatric surgery (MBS) to prevent recurrent weight gain in patients who are normal weight or overweight. Gastric band removal is frequently required due to long-term complications such as slippage, which raises an important question: should revisional MBS be considered for weight maintenance in patients who have successfully lost weight after gastric banding? With the increasing use of obesity management medications and the associated successful weight loss, we anticipate that more patients will discontinue pharmacological treatment after reaching a normal weight or overweight range. However, many of these patients may still seek MBS for long-term weight maintenance. We question whether weight maintenance should be considered an indication for MBS in patients who are currently normal weight or overweight but have a history of severe obesity and must discontinue their current obesity treatment.