A Decade of Bariatric and Metabolic Surgery Evolution in Asia-Pacific Amid COVID-19

Overview

Over the past decade, bariatric and metabolic surgery in the Asia-Pacific region has seen significant growth in patient numbers, surgeon availability, and institutional support, despite challenges posed by the COVID-19 pandemic. National societies reported changes in surgical indications, insurance coverage, and procedural trends from 2010 to 2020, highlighting evolving clinical practices.

Background

The International Federation for the Surgery of Obesity and Metabolic Disorders Asia-Pacific Chapter (IFSO-APC) was established in 2008 to unify bariatric and metabolic surgery societies across the region. Initial consensus defined surgical indications based on BMI and comorbidities such as type 2 diabetes mellitus (T2DM). Over time, the number of surgeries and participating national societies increased, reflecting growing recognition of obesity and metabolic disorders as public health concerns. The 2021 IFSO-APC Virtual Meeting presented a comprehensive review of changes over the decade, including the impact of the COVID-19 pandemic on surgical practice.

Data Highlights

Key Findings

• The number of bariatric/metabolic surgeries in the Asia-Pacific region increased approximately 2.5-fold from 2013 to 2018.
• National societies participating in data reporting expanded from 2-5 in 2011 to 14 by 2021, improving data comprehensiveness.
• Indications for surgery remained consistent, with bariatric surgery recommended for BMI ≥35 kg/m2 and metabolic surgery for BMI ≥30 kg/m2 with T2DM or metabolic syndrome.
• Public health insurance coverage for bariatric/metabolic surgery increased in several countries between 2010 and 2020, facilitating access.
• The COVID-19 pandemic influenced surgical volumes and practices in 2020, with variations across countries.
• Data collection methods evolved to include national registries, surveys, and personal communications, enhancing data quality and availability.

Clinical Implications

Clinicians should recognize the expanding role and accessibility of bariatric and metabolic surgery in the Asia-Pacific region, supported by growing surgeon numbers and institutional infrastructure. Consistent surgical indications aligned with BMI and metabolic comorbidities facilitate standardized patient selection. Awareness of COVID-19’s impact on surgical services is essential for planning and resource allocation.

Conclusion

The past decade has witnessed substantial growth and evolution in bariatric and metabolic surgery across the Asia-Pacific region, with improved data reporting and expanded access despite pandemic-related challenges. Continued collaboration and data sharing among national societies will support further advancements in patient care.

References

1. IFSO-APC National Reports 2011 -- Consensus and Data Collection
2. WHO Database -- Obesity Prevalence Data
3. IDF Diabetes Atlas -- T2DM Prevalence Data