1. Evaluation of Current Eligibility Criteria for Bariatric Surgery Diabetes prevention and risk factor changes in the Swedish Obese Subjects (SOS) study Featured Article: Kajsa Sjöholm, Ph.D., Åsa Anveden, M.D., Markku Peltonen, Ph.D., Peter Jacobson, M.D., Ph.D., Stefano Romeo, M.D., Ph.D., Per-Arne Svensson, Ph.D., Lars Sjöström, M.D., Ph.D., Lena M.S. Carlsson, M.D., Ph.D. Diabetes Care Volume 36: 1335-1340 May, 2013

2. STUDY OBJECTIVE Patients with BMI <35 kg/m2 and patients with BMI of 35–40 kg/m2 without comorbidities are not eligible for bariatric surgery We used Swedish obese subjects to explore long-term outcomes in noneligible versus eligible patients Sjöholm K. et al. Diabetes Care 2013;36:1335-1340

3. STUDY DESIGN AND METHODS Study involved 2,010 obese patients who underwent bariatric surgery and 2,037 contemporaneously matched obese controls Age 37–60 years and BMI ≥34 kg/m2 in men and ≥38 kg/m2 in women Effect of surgery was assessed in patients who do (n = 3,814) and do not (n = 233) meet eligibility criteria Date of analysis 1 January 2012 Follow-up time was up to 20 years, with a median of 10 years Sjöholm K. et al. Diabetes Care 2013;36:1335-1340

5. RESULTS Cardiovascular risk factors were significantly improved both in noneligible and eligible individuals after 10 years of follow- up Surgery reduced diabetes incidence in both noneligible and eligible groups No difference detected in the effect of surgery between the groups Sjöholm K. et al. Diabetes Care 2013;36:1335-1340

7. CONCLUSIONS Bariatric surgery drastically reduced the incidence of type 2 diabetes both in noneligible and eligible patients and improved cardiovascular risk factors in both groups Strict BMI cutoffs are of limited use for bariatric surgery prioritization if the aim is to prevent diabetes and improve cardiovascular risk factors Sjöholm K. et al. Diabetes Care 2013;36:1335-1340