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CHAPTER THREE

The Birth and Growth of IFSO:
From the First Meeting to a

Global Federation of Chapters

Martin Fried, Karl Miller, Henry Buchwald, Rafael Álvarez Cordero,
Natan Zundel, Harry Frydenberg, Lilian Kow, Khaled Gawdat

A Global Need for Unity in Metabolic Bariatric Surgery

Martin Fried and Karl Miller

The early 1990s represented a period of profound transformation in the understanding and
treatment of obesity. Metabolic bariatric surgery (MBS) was rapidly evolving from a niche discipline
into an increasingly recognized therapeutic option for severe obesity and its related diseases. On
different continents, pioneering surgeons were refining operative techniques, publishing early
outcomes, and demonstrating that surgical intervention could achieve meaningful and sustained
weight loss, while improving obesity-related diseases. Despite this progress, the field remained
fragmented. Scientific exchange was largely confined to national or regional meetings, and
opportunities for meaningful international collaboration were limited.

In Europe, the International Obesity Surgery Symposium, led by Nicola Scopinaro, was already
established as an important forum for scientific discussion. In North America, the annual meeting of
the American Society for Bariatric Surgery (ASBS) brought together an expanding surgical
community committed to advancing the field. However, no single organization existed to unite
experts globally, establish shared scientific standards, test emerging techniques and technologies,
or represent the growing discipline on an international level. Surgeons and researchers realized that
a truly global scientific platform for MBS was urgently needed.
Even in these early years, many leaders in the field understood that collaboration with physicians,
endocrinologists, nutrition specialists, psychologists, and other healthcare professionals would be
essential to research in the field and improvement of patient care. The seeds of the multidisciplinary
philosophy that would later shape IFSO were being planted.

Minneapolis 1994: The First Conversations

An important inflection point occurred during the 11th Annual Meeting of the American Society for
Bariatric Surgery (ASBS), held in Minneapolis, Minnesota, from 8-11 June, 1994. Although the official
scientific program focused on the latest advances in MBS, equally significant discussions were taking
place informally among international participants. Approximately twenty-five MBS surgeons from
outside the United States (US), including fifteen from Europe, gathered to discuss the possibility of

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