Page 82 - IFSO-History-Book-Digital-File

CHAPTER EIGHT

IFSO Now: The Dawn of Combination
Therapies and Lifelong Care

Khaled Gawdat

When the International Federation for the Surgery of Obesity was formed in Stockholm in 1995, the
global landscape of metabolic bariatric surgery (MBS) care was profoundly different. Led by our
visionary founding president, the late Nicola Scopinaro, we began with a singular focus: to unite
surgeons worldwide in standardizing and advancing operative treatments for severe obesity. As I
look back on our history, I am struck by how our federation has not only adapted to, but actively
driven, the scientific awakening surrounding adiposity. Our evolution is a testament to our relentless
commitment to clinical truth.

The First Paradigm Shift

From weight loss to metabolic surgery… Our first major transformation occurred when the clinical
evidence became undeniable: MBS was achieving far more than mechanical weight restriction. We
were observing the rapid remission of type 2 diabetes and the profound reversal of severe
metabolic syndromes, often well before significant weight loss had materialized.

To accurately reflect this physiological reality, our mission and name evolved to the International
Federation for the Surgery of Obesity and Metabolic Disorders. This critical shift, championed over
the years by pioneering presidents who recognized the broader metabolic implications of our
procedures, marked our transition from weight-loss surgeons to metabolic surgeons.

Throughout this era of rapid innovation, our official journal, Obesity Surgery, stood as the bedrock of
our scientific community. In 2026, OBSU saw its impact factor (IF) increase from 3.1 to 3.4, which is a
significant increase. This rise in IF moved OBSU to one of the highest IFs among English-language
surgery journals and the highest IF for all journals dedicated to MBS. OBSU remains a definitive
reference for MBS surgeons around the world, continuously publishing the peer-reviewed literature
that heralds the surgical innovations that guided this metabolic awakening.

Standardizing Care and Expanding Access: The 2022 Guidelines

A core pillar of IFSO’s mission has always been the regulation and standardization of MBS
procedures through rigorous position statements and joint scientific guidelines. Historically, from
1991-2022, the criteria for patient selection were dictated by the United States National Institutes of
Health (NIH). Remarkably, those initial guidelines remained static for more than 30 years, even as our
surgical techniques and scientific understanding transformed.

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