Minister of Health Issues Ministerial Decision to Regulate Obesity Surgeries and Non-Surgical Interventional Procedures in the Public and Private Sectors

Today, Tuesday, Health Minister Dr. Ahmed Al-Awadi issued a ministerial decision to regulate bariatric surgeries and non-surgical interventional procedures in health facilities across both the public and private sectors.

In a press statement, the Ministry of Health said the decision establishes a comprehensive regulatory framework for performing these procedures, based on clear standards covering health facilities, practitioners, patient selection, evaluation and follow-up mechanisms, and the monitoring of outcomes and complications.

It clarified that the decision takes effect from the date of its issuance, will be published in the Official Gazette, and repeals all previous decisions or provisions that conflict with its stipulations.

The decision defines the scope of bariatric and metabolic surgeries, classifying them into primary, revisional, and malabsorptive procedures, while also regulating non-surgical interventional procedures such as endoscopic sleeve gastroplasty and intragastric balloons, specifying the requirements and standards for each category.

It also identifies the approved primary surgical procedures, including sleeve gastrectomy, classic Roux-en-Y gastric bypass, single-anastomosis gastric bypass (SAGB), and adjustable gastric banding. The decision stipulates that there is no fixed upper age limit for bariatric surgery, with eligibility determined based on the patient’s overall health status.

Furthermore, the decision permits consideration of bariatric surgery for selected children and adolescents aged 12 to 17, subject to specific criteria, comprehensive evaluation, approval by a multidisciplinary team, and informed written consent from parents or legal guardians. It mandates medical follow-up for at least two years post-surgery and sets specific criteria for body mass index (BMI) and comorbidities, restricting recommended procedures primarily to sleeve gastrectomy and gastric bypass in specific cases.

The decision also regulates revisional surgeries and malabsorptive procedures, outlining conditions under which revisional surgery may be considered, such as weight regain, insufficient weight loss after previous bariatric surgery, inadequate improvement in comorbidities, or management of certain complications like severe gastroesophageal reflux disease. It requires that cases for revisional and malabsorptive surgeries be reviewed and officially approved by a multidisciplinary team prior to surgery.

Regarding malabsorptive procedures, the decision states they cannot be performed as primary interventions and must be carried out exclusively by an experienced surgeon with proven expertise in the specific procedure, thereby enhancing patient safety and ensuring that more complex procedures are entrusted to qualified specialists.

The Ministry noted that the decision restricts bariatric surgeries to government hospitals or licensed and accredited private hospitals. For private hospitals, it requires adequate infrastructure, including intensive care units, medical imaging services, laboratory facilities, and comprehensive pre-surgical evaluation protocols.

The decision mandates immediate reporting of serious complications classified as grade 3 or higher according to the Clavien-Dindo classification, as well as any deaths, with defined reporting pathways for both the public and private sectors. It also stipulates the establishment and maintenance of a national bariatric surgery registry containing all cases, outcomes, and complications to support the monitoring of practice quality and outcome evaluation at the national level.

Additionally, the decision regulates patient transfers from private to government hospitals, reaffirming adherence to the Ministry of Health’s approved patient transfer policy. It requires that all medical reports and test results be attached, and that the surgical procedure or surgical notes be recorded within 24 hours.

The Ministry confirmed that the decision established professional qualification requirements for physicians, stipulating that surgeons must be either senior specialists or consultants in general surgery and hold accredited training or certification in bariatric surgery, in accordance with the specified regulations. It also mandated surgical departments to maintain and periodically renew updated lists of experienced surgeons in this field, while simultaneously regulating the practice of visiting surgeons, their licensing procedures, and the approval of the surgical procedures they intend to perform.