Table 2.

National guidance for bariatric surgery

Country	BMI level, kg/m2		Comorbidities	Requirements for conservative treatment prior to bariatric surgery	Source
	Without comorbidities	With comorbidities
Belgium	40	35	T2DM, hypertension, OSA	Not available	[14]
Denmark	40	35	T2DM, hypertension, OSA, PCOS, knee osteoarthritis	Sustainable weight loss not achieved by conventional treatment	[15]
	50	35			[16]
England	40	35	T2DM, hypertension, OSA, knee osteoarthritis	Failure of non-surgical methods for at least 6 months	[17]
	50			Bariatric surgery is recommended as a first-line treatment option
	40			Weight loss programme for 12–24 months	[18]
	50			Weight loss programme for 6 months minimum
France	40	35	T2DM, hypertension, OSA, knee osteoarthritis	Failure of nutritional, dietary and medical treatment; psychotherapy conducted for 6–12 months; absence of sufficient weight loss or lack of maintenance of weight loss	[19]
Germany	40	35	T2DM, hypertension	Failure of conservative management	[20]
Italy	40	35	T2DM, hypertension, knee osteoarthritis, severe psychological problems	Failure of proper medical treatment including inadequate weight loss or poor maintenance of weight loss	[13]
Sweden	40	35	T2DM, OSA, pregnancy issues, knee osteoarthritis	Failure of weight loss using non-surgical methods	[21]

BMI body mass index, OSA obstructive sleep apnea, PCOS polycystic ovary syndrome, T2DM type 2 diabetes