Referral criteria and assessment for bariatric surgery: summary of updated NICE guidance

### What you need to know

Until this year, the National Institute for Health and Care Excellence (NICE) had recommended bariatric surgery as a treatment option for people with a body mass index (BMI, weight (kg)/(height (m)2) of ≥40, or with a BMI of 35-39.9 with a significant obesity-related comorbidity, only if all non-surgical interventions had been tried first and the person was receiving management in a tier 3 service. New NICE guidelines now recommend that these groups of people should be offered a comprehensive assessment for bariatric surgery without the requirement for all non-surgical interventions to have been tried first, or for patients to already be under the management of a tier 3 service. The guidelines also provide an evidence-based list of significant health conditions that can be improved by bariatric surgery, which will help clinicians make decisions about who to offer an assessment to, and recommendations on what the assessment for surgery should include.

This article summarises updated recommendations published in July 2023, referring to the updated NICE guidance on weight management.1 These guidelines update the previously published guidelines on management of obesity, first published in 2006 and updated in 2014.2

NICE recommendations are based on systematic reviews of best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on the guideline committee’s experience and opinion of what …

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