Minister of Health Dr. Ahmed Al-Awadi issued Ministerial Decree No. 221/2026 on Tuesday to define requirements, regulations and standards for bariatric and metabolic surgeries together with non-surgical interventional procedures performed in both public and private healthcare facilities. The decree classifies these surgeries into primary, reconstructive and malabsorption categories while separately regulating endoscopic sleeve gastrectomy and intragastric balloon procedures. It establishes a body mass index threshold of 35 or higher for primary surgery, or 30 to 34.9 with comorbidities, and recommends non-surgical options before surgical intervention.
Approved primary procedures under the decree include sleeve gastrectomy, classic gastric bypass, mini-gastric bypass and gastric banding, with no fixed age limit set for adults as eligibility depends on individual health assessments. For patients aged 12 to 17, the decree requires multidisciplinary team approval, parental consent and additional clinical safeguards before any procedure can proceed. All patients must receive structured medical follow-up for a minimum of two years following surgery or intervention according to the ministerial text.
Reconstructive procedures are restricted to defined clinical indications and require multidisciplinary team review, while the decree explicitly prohibits malabsorption operations as a primary treatment modality. Non-surgical interventions become available at a body mass index of 27 or above yet remain unavailable to anyone under 18 and must be performed exclusively by qualified specialists. Both surgical and non-surgical options are confined to government hospitals or licensed private facilities that maintain the required infrastructure, equipment and support services.
The Ministry of Health’s Kuwait National Bariatric Registry 2023 report documented 6,484 bariatric surgery cases, of which 5,270 were primary procedures, 874 were revisions and 340 involved balloon insertions. That registry data, released by the ministry, showed sleeve gastrectomy accounting for 94.3 percent of primary operations, followed by one-anastomosis gastric bypass at 2.8 percent and Roux-en-Y gastric bypass at 1.5 percent. Average preoperative body mass index reached 45.7 for male patients and 43.2 for females, figures that exceed global registry averages.
A separate 2023 study published in the Journal of Medical Economics found that 44 percent of Kuwait’s population lives with obesity, placing considerable demand on health services that prompted successive regulatory updates. The Ministry of Health first began organising gastric sleeve surgeries through a 2013 resolution that set basic patient prerequisites and facility conditions. Tuesday’s decree expands those earlier rules with comprehensive classifications, mandatory reporting of Clavien-Dindo grade 3 or higher complications and deaths, plus explicit infrastructure requirements for all approved centres.
