Specialty groups offer updated guidelines on care surrounding bariatric surgery

A group of medical specialty organizations recently updated its guidelines on bariatric surgery.

The guidelines cover perioperative nutritional, metabolic, and nonsurgical support of patients undergoing bariatric procedures. The update was commissioned by the American Association of Clinical Endocrinologists/American College of Endocrinology, the Obesity Society, the American Society for Metabolic and Bariatric Surgery, the Obesity Medicine Association, and the American Society of Anesthesiologists. The guidelines were also endorsed by the American Society for Nutrition, the Obesity Action Coalition, and the American Society for Parenteral and Enteral Nutrition. They were published by Endocrine Practice on Nov. 4.

The updates were based on evidence published from 2013 to the present, as well as expert opinion. Questions addressed by the recommendations include which patients are candidates for bariatric procedures, which types of bariatric procedures should be offered, and how patients should be cleared for a bariatric procedure and managed before it. Postoperative care, including criteria for hospitalization after a procedure, is also covered. There are 85 recommendations that have updated supporting evidence, including 61 revised and 12 new.

The guidelines include information about new and emerging surgical and nonsurgical bariatric procedures. Checklists are provided to assist clinicians in decision making about bariatric procedures. The guidelines also highlight the importance of team-based care for these patients and enhanced recovery after bariatric surgery.

“Bariatric procedures remain a safe and effective intervention for higher-risk patients with obesity. Clinical decision-making should be evidence-based within the context of a chronic disease. A team approach to perioperative care is mandatory with special attention to nutritional and metabolic issues,” the guidelines said.