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The Bariatric Standards of the American College of Surgeons

Bariatrics is the field of medicine that deals with the treatment of obesity. While there are several nonsurgical options for treating obesity, it is sometimes necessary to resort to surgery in order to give an obese patient a basic standard of life. The American College of Surgeons, an organizing body of surgeons from the United States and Canada founded in 1913, has set certain standards and regulations for bariatric surgery.

  1. Hospital Levels

    • The American College of Surgeons recognizes certain hospitals as being level one centers for the purpose of bartiatric surgery. These hospitals must have done at least 125 bariatric surgeries in the last 12 months, must provide all data from the last two years and must have a director of bariatric surgery. Level two hospitals must have done at least 25 bartiatric surgeries in the last 12 months. The American College of Surgeons also recognizes outpatient hospitals, though the only type of surgery recognized as legitimate by outpatient hospitals is laparoscopic adjustable gastric banding.

    Surgeon Qualifications

    • All surgeons performing bariatric surgery, at any hospital level, must meet certain standards. These include completing a general surgery residency where they perform at least 25 laparoscopic adjustable gastric bandings and 10 open bariatric operations; completing coursework in bariatric surgery, including attending at least 12 hours of meeting every two years at a bariatric surgery meeting; and having their first five independently performed bariatric surgeries subsequently reviewed by a committee that includes their hospital's chief of surgery.

    Patient Education

    • Patients must give informed consent to have bariatric surgery done in order for a facility to be accredited by the American College of Surgeons. Thus, doctors at accredited facilities must give patients printed materials that include a description of preoperative and postoperative care. Additionally, after the surgery, all accredited institutions must provide dietary, exercise, psychological and plastic surgery consulting in order to help patients adjust. Hospitals that live up to the bariatric standards of the college must prove at least one year of contact with their patients after the surgery.

    Adolescent Standards

    • The American College of Surgeons sets a different standard for the bariatric surgery of adolescents, partially because the college believes that education and lifestyle adjustment are the best approaches for weight loss in adolescents. According to the college's standards, surgeons must prove they went through at least six months of failed-attempt weight management programs with adolescents before considering surgery as an option. Additionally, the adolescent in question must be psychologically mature and give informed consent. Level two hospitals are not allowed to perform bariatic surgeries on adolescents.

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