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Fourth IFSO Global Registry Report

IFSO publishes Fourth IFSO Global Registry Report

This latest report includes 394,431 operation records from 51 countries from five continents

The Fourth IFSO Global Registry Report (2018) has been released at the XXIII World Congress of the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) in Dubai, UAE. Published by Dendrite Clinical Systems, under the auspices of the IFSO, the publication reports data from more than 50 countries on over 394,000 operations including baseline obesity-related disease, operation types, operative outcomes and disease status after bariatric surgery.

IFSO President, Professor Jacques Himpens

The report is the culmination of years of research and analyses from the IFSO Global Registry Project, which was established in January 2014 to demonstrate that it is possible to merge and analyse bariatric and metabolic surgical data from different countries and centres.

“The IFSO Global Registry is by far the best international data registry in metabolic / bariatric surgery available so far. It gives a clear insight in the geographic and cultural differences in metabolic surgery across the globe,” said IFSO President, Professor Jacques Himpens. “The Fourth IFSO Global Registry Report provides an excellent working document for surgeons and other health care professionals, as well as politicians and stakeholders and should allow for better insights in health policies, private and public alike. Hence, it will eventually benefit the universal patient suffering from obesity and its related diseases. And this happens to be congruent with IFSO’s mission.”

This latest report includes 394,431 operation records from 51 countries from five continents, and has detailed information on:

  • 165,138 Roux en Y gastric bypass operations (41.9% of all the records submitted)
  • 128,417 sleeve gastrectomy procedures (32.6%)
  • 47,858 gastric banding operations (12.1%); and
  • 19,634 one anastomosis gastric bypass procedures (5.0%)

The publication has some interesting county-to-country analysis and notes a wide variation of BMI pre-surgery between different contributor countries, medians ranging from 34.2kgm2 in South Korea to 49.1kgm2 in Germany. There was also a wide variation in the country-specific gender ratios, ranging from 50.9% female in Georgia to 100% in South Korea.

In addition, Mexico (81.0%), Colombia (79.2%) and Brazil (73.6%) reported the highest proportions of gastric bypass surgery, whereas Australia (100.0%), Saudi Arabia (100.0%) and Guadeloupe (99.5%) reported the highest rates of sleeve gastrectomy operations.

Prior to surgery, 19.8% of patients were on medication for type 2 diabetes (inter-country variation: 4.5-97.7%), 30.6% were treated for hypertension (inter-country variation: 10.9-92.6%), 12.4% of patients were on medication for depression (inter-country variation: 0.0-54.4%), 24.3% of patients required treatment for musculo-skeletal pain (inter-country variation: 0.0-65.1%), 18.6% of patients had sleep apnoea (inter-country variation: 0.0-74.3%) and 17.0% of patients had gastro-oesophageal reflux disorder (inter-country variation: 0.0-54.8%).


Following surgery, the report states that the average percentage weight loss was 30.1% and after primary surgery 62.4% of those taking medication for type 2 diabetes beforehand were no longer on medication one year after surgery. The proportion of patients no longer treated for diabetes was highly dependent on weight loss achieved.

There are 275,834 valid follow up records included in the report and the average percentage weight loss 28.9% one year after surgery, one year after primary surgery 66.1% of those taking medication for type 2 diabetes beforehand were no longer on medication and the proportion of patients no longer treated for diabetes was highly dependent on weight loss achieved.

The report found that there were also significant reductions in the rates of treatment for depression, hypertension and musculo-skeletal pain, as well as a fall in the rates of confirmed sleep apnoea one year after bariatric surgery.

Other highlights of the report show:

  • 88.5% of patients who had a gastric band inserted were discharged within one day of their operation
  • 84.1% of gastric bypass patients were discharged within two days of surgery
  • 84.5% of sleeve gastrectomy patients went home within three days of their operation
  • Unsurprisingly, 99.3% of all operations were performed laparoscopically
  • The Obesity Surgery Mortality Risk Score 1 (OSMRS) varied widely by country with Georgia, Bulgaria and Hong Kong reporting the highest-risk patient populations (OSMRS groups B & C:78.7%. 72.2% and 66.7% respectively), with South Korea, Bolivia and Kuwait reporting the least risk patient populations (OSMRS groups B & C: 12.5%, 20.5% and22.2% respectively)

“Thank you to all those surgeons who have committed their data for inclusion in this second report, your contribution is very much appreciated. Bariatric surgery has great potential to improve health in a vast number of patients in a cost effective manner; however, it is made available to very few obese people who could benefit from it,” writes Mr Richard Welbourn in the introduction of the report. “The data presented are not intended to be a definitive global representation of bariatric surgery, as data from many countries with large volumes of surgery are not yet included. However, the report is the start of a process that shows what can be achieved within the constituent countries of IFSO. I encourage all key stakeholders in bariatric surgery (especially surgeons, providers and commissioners of care) to embrace this data collection and reporting process at individual clinics and hospitals, and onwards / upwards at both national and international levels.”

“Together with IFSO, we are delighted to publish this fourth report. I would like to thank all the contributors for submitting their data,” said Dr Peter Walton, Managing Director of Dendrite Clinical Systems. “I hope this important publication not only suggests many international research projects that could be undertaken but advances the status and acceptability of bariatric and metabolic surgery worldwide, helping promote an increase in bariatric and metabolic surgery provision.”

The Global IFSO Registry Project was headed by Jacques Himpens (Belgium), Richard Welbourn (UK), Almino Ramos (Brazil), Peter Walton and Robin Kinsman (Dendrite Clinical Systems Ltd, UK).

To download the report, please click here

If you are interested in participating in the Fifth IFSO Global Registry Report, please email: for more information.

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