Since the landmark 1991 NIH Consensus Development Conference, Body Mass Index (BMI) thresholds have guided patient selection for bariatric surgery worldwide. The 2022 joint statement from International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) and American Society of Metabolic and Bariatric Surgery (ASMBS) revised these thresholds for Asian populations, specifying that BMI ≧25 kg/m
2 defines clinical obesity, and that individuals with a BMI ≧27.5 kg/m
2 should be offered metabolic and bariatric surgery (MBS) [
1]. This adjustment was intended to account for the elevated cardiometabolic risk observed at lower BMI levels in Asian populations compared with Western populations, reflecting the disproportionate impact of visceral adiposity and the higher prevalence of type 2 diabetes mellitus (T2DM) and cardiovascular disease in these individuals [
2]. …