Patient Pathways to Bariatric Surgery: What Pre-operative Medical Weight Management Programmes Exist Globally; Results of an International Survey

Danielle Clyde, Maria Boland, Gerard McCabe, William Cambridge, Leo Brown, Kerry Aitken, Gillian Drummond, Brian Joyce, Andrew de Beaux, B Tulloh, Osama Moussa, Wah Yang, Brijesh Madhok, Peter Lamb, Kamal Mahawar, Andrew Robertson

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Introduction
Bariatric surgery is an accepted treatment worldwide for patients with obesity due to its proven metabolic effects. However, there are variations worldwide in clinical criteria that must be met to qualify for surgery. This study aims to explore global established practice and opinions on preoperative work up for bariatric surgery.
Methods
A review of literature and international guidelines was performed by a multidisciplinary team and used to develop an online questionnaire survey. This was distributed to bariatric professionals electronically.
Results
Two hundred forty-four bariatric healthcare professionals, from 224 medical centres across 57 countries completed the survey. The majority of respondents were surgeons (67.2%,) and the remainder were other multidisciplinary professionals. Over half of medical centres were public hospitals (50.8%), with most performing over 200 procedures per year (30.3%). Only 68.4% (n=167) of respondent hospitals used recognised referral guidelines, however 81.9% felt there should be written referral criteria (p < 0.001). In 70.5% of units’ patients underwent a medical weight management programme (MWMP) as part of their preparation for surgery and 71.3% of respondents felt that meeting weight loss criteria was a predictor of better surgical outcomes. Significant differences were identified worldwide in the criteria used to determine progression to surgery (p < 0.001); time spent in MWMP prior to surgery (p < 0.001); and the roles of members forming the bariatric MDT (p = 0.006).
Conclusion
This study has identified significant variation in global bariatric surgery practices and highlights the responsibility that societies such as International Federation for the Surgery of Obesity and and Metabolic Disorders (IFSO) and The Upper GI Surgery Society (TUGSS) have in promoting universal clinical guidelines.

Original languageEnglish
JournalJournal of Bariatric Surgery
Early online date10 Aug 2023
DOIs
Publication statusE-pub ahead of print - 10 Aug 2023

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