E defines morbid obesity ‘for the purposes of the guidance’ as:A BMI either equal to or greater than 40 kg/m2, or between 35 kg/m2 and 40 kg/m2 in the presence of significant comorbid conditions that could be improved by weight loss.Other authorities use a broader definition. According to Balsiger et al:Patients have morbid obesity when they are 100% or greater above ideal body weight (IBW), are at least 100 lb above IBW or have a BMI of over 35. A strictly weight-based definition is not appropriate, however, and a better definition of morbid obesity includes patients who have direct, weight-related serious morbidity, such as mechanical arthropathy, hypertension, type 2 diabetes, lipid related cardiac disease, and sleep apnoea.

People suffering from morbid obesityIn 1998, an estimated 0.6% of men and 1.9% of women in England and Wales had a BMI of 40 kg/m2 or more – this is equivalent to 124 000 men and 412 700 women. People with a BMI >35 have a rate of mortality at any given age double that of someone with a BMI of 20-25.*55/312/5*

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