Metabolic surgery in treatment of obese Japanese patients with type 2 diabetes: a joint consensus statement from the Japanese Society for Treatment of Obesity, the Japan Diabetes Society, and the Japan Society for the Study of Obesity

Akira Sasaki¹, Koutaro Yokote², Takeshi Naitoh³, Junji Fujikura⁴, Karin Hayashi⁵, Yushi Hirota⁶, Nobuya Inagaki⁴, Yasushi Ishigaki⁷, Kazunori Kasama⁸, Eri Kikkawa⁸, Hidenori Koyama⁹, Hiroaki Masuzaki¹⁰, Takeshi Miyatsuka¹¹, Takehiro Nozaki¹², Wataru Ogawa⁶, Masayuki Ohta¹³, Shinichi Okazumi¹⁴, Michio Shimabukuro¹⁵, Iichiro Shimomura¹⁶, Hitoshi Nishizawa¹⁶, Atsuhito Saiki¹⁷, Yosuke Seki⁸, Nobuhiro Shojima¹⁸, Motoyoshi Tsujino¹⁹, Satoshi Ugi²⁰, Hiroaki Watada¹¹, Toshimasa Yamauchi¹⁸, Takashi Yamaguchi¹⁷, Kohjiro Ueki²¹, Takashi Kadowaki²², Ichiro Tatsuno²³; Joint Committee in the Japanese Society for Treatment of Obesity, the Japan Diabetes Society, the Japan Society for the Study of Obesity

Affiliations

¹ Department of Surgery, Iwate Medical University, 2-1-1 Idaidori, Yahaba, 028-3695 Japan.
² Department of Endocrinology Hematology, and Gerontology, Graduate School of Medicine, Chiba University, Chiba, Japan.
³ Department of Lower Gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
⁴ Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan.
⁵ Department of Neuropsychiatry, Toho University Sakura Medical Center, Sakura, Chiba Japan.
⁶ Division of Diabetes and Endocrinology, Kobe University Graduate School of Medicine, Kobe, Japan.
⁷ Division of Diabetes and Metabolism, Department of Internal Medicine, Iwate Medical University, Yahaba, Japan.
⁸ Weight loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan.
⁹ Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo College of Medicine, Nishinomiya, Hyogo Japan.
¹⁰ Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology, Department of Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
¹¹ Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
¹² Clinical Trial Center, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan.
¹³ Global Oita Medical Advanced Research Center for Health, Oita University, Oita, Japan.
¹⁴ Department of Surgery, Toho University Sakura Medical Center, Sakura, Chiba Japan.
¹⁵ Department of Diabetes, Endocrinology and Metabolism, School of Medicine, Fukushima Medical University, Fukushima, Japan.
¹⁶ Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.
¹⁷ Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Sakura, Japan.
¹⁸ Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
¹⁹ Department of Endocrinology and Metabolism, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.
²⁰ Division of Endocrinology and Metabolism, Department of Medicine, Shiga University of Medical Science, Otsu, Japan.
²¹ Department of Molecular Diabetic Medicine, Diabetes Research Center, National Center for Global Health and Medicine, Tokyo, Japan.
²² Toranomon Hospital, Tokyo, Japan.
²³ Chiba Prefectural University of Health Sciences, Chiba, Japan.

PMID: 34777929
PMCID: PMC8574153
DOI: 10.1007/s13340-021-00551-0

Practice Guideline

Metabolic surgery in treatment of obese Japanese patients with type 2 diabetes: a joint consensus statement from the Japanese Society for Treatment of Obesity, the Japan Diabetes Society, and the Japan Society for the Study of Obesity

Akira Sasaki et al. Diabetol Int. 2021.

. 2021 Nov 8;13(1):1-30.

doi: 10.1007/s13340-021-00551-0. eCollection 2022 Jan.

Authors

Affiliations

¹ Department of Surgery, Iwate Medical University, 2-1-1 Idaidori, Yahaba, 028-3695 Japan.
² Department of Endocrinology Hematology, and Gerontology, Graduate School of Medicine, Chiba University, Chiba, Japan.
³ Department of Lower Gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
⁴ Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan.
⁵ Department of Neuropsychiatry, Toho University Sakura Medical Center, Sakura, Chiba Japan.
⁶ Division of Diabetes and Endocrinology, Kobe University Graduate School of Medicine, Kobe, Japan.
⁷ Division of Diabetes and Metabolism, Department of Internal Medicine, Iwate Medical University, Yahaba, Japan.
⁸ Weight loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan.
⁹ Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo College of Medicine, Nishinomiya, Hyogo Japan.
¹⁰ Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology, Department of Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
¹¹ Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
¹² Clinical Trial Center, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan.
¹³ Global Oita Medical Advanced Research Center for Health, Oita University, Oita, Japan.
¹⁴ Department of Surgery, Toho University Sakura Medical Center, Sakura, Chiba Japan.
¹⁵ Department of Diabetes, Endocrinology and Metabolism, School of Medicine, Fukushima Medical University, Fukushima, Japan.
¹⁶ Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.
¹⁷ Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Sakura, Japan.
¹⁸ Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
¹⁹ Department of Endocrinology and Metabolism, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.
²⁰ Division of Endocrinology and Metabolism, Department of Medicine, Shiga University of Medical Science, Otsu, Japan.
²¹ Department of Molecular Diabetic Medicine, Diabetes Research Center, National Center for Global Health and Medicine, Tokyo, Japan.
²² Toranomon Hospital, Tokyo, Japan.
²³ Chiba Prefectural University of Health Sciences, Chiba, Japan.

PMID: 34777929
PMCID: PMC8574153
DOI: 10.1007/s13340-021-00551-0

Erratum in

Correction to: Metabolic surgery in treatment of obese Japanese patients with type 2 diabetes: a joint consensus statement from the Japanese Society for Treatment of Obesity, the Japan Diabetes Society, and the Japan Society for the Study of Obesity.
Sasaki A, Yokote K, Naitoh T, Fujikura J, Hayashi K, Hirota Y, Inagaki N, Ishigaki Y, Kasama K, Kikkawa E, Koyama H, Masuzaki H, Miyatsuka T, Nozaki T, Ogawa W, Ohta M, Okazumi S, Shimabukuro M, Shimomura I, Nishizawa H, Saiki A, Seki Y, Shojima N, Tsujino M, Ugi S, Watada H, Yamauchi T, Yamaguchi T, Ueki K, Kadowaki T, Tatsuno I; Joint Committee in the Japanese Society for Treatment of Obesity, the Japan Diabetes Society, the Japan Society for the Study of Obesity. Sasaki A, et al. Diabetol Int. 2021 Nov 26;13(1):31-32. doi: 10.1007/s13340-021-00561-y. eCollection 2022 Jan. Diabetol Int. 2021. PMID: 35059239 Free PMC article.
Correction to: Metabolic surgery in treatment of obese Japanese patients with type 2 diabetes: a joint consensus statement from the Japanese Society for Treatment of Obesity, the Japan Diabetes Society, and the Japan Society for the Study of Obesity.
Sasaki A, Yokote K, Naitoh T, Fujikura J, Hayashi K, Hirota Y, Inagaki N, Ishigaki Y, Kasama K, Kikkawa E, Koyama H, Masuzaki H, Miyatsuka T, Nozaki T, Ogawa W, Ohta M, Okazumi S, Shimabukuro M, Shimomura I, Nishizawa H, Saiki A, Seki Y, Shojima N, Tsujino M, Ugi S, Watada H, Yamauchi T, Yamaguchi T, Ueki K, Kadowaki T, Tatsuno I; Joint Committee in the Japanese Society for Treatment of Obesity, the Japan Diabetes Society, the Japan Society for the Study of Obesity. Sasaki A, et al. Diabetol Int. 2021 Dec 7;13(1):33-34. doi: 10.1007/s13340-021-00562-x. eCollection 2022 Jan. Diabetol Int. 2021. PMID: 35059240 Free PMC article.

Abstract

Bariatric surgery has been shown to have a variety of metabolically beneficial effects for patients with type 2 diabetes (T2D), and is now also called metabolic surgery. At the 2nd Diabetes Surgery Summit held in 2015 in London, the indication for bariatric and metabolic surgery was included in the "algorithm for patients with type T2D". With this background, the Japanese Society for Treatment of Obesity (JSTO), the Japan Diabetes Society (JDS) and the Japan Society for the Study of Obesity (JASSO) have formed a joint committee to develop a consensus statement regarding bariatric and metabolic surgery for the treatment of Japanese patients with T2D. Eventually, the consensus statement was announced at the joint meeting of the 38th Annual Meeting of JSTO and the 41st Annual Meeting of JASSO convened in Toyama on March 21, 2021. In preparing the consensus statement, we used Japanese data as much as possible as scientific evidence to consider the indication criteria, and set two types of recommendation grades, "recommendation" and "consideration", for items for which recommendations are possible. We hope that this statement will be helpful in providing evidence-based high-quality care through bariatric and metabolic surgery for the treatment of obese Japanese patients with T2D.

Supplementary information: The online version contains supplementary material available at 10.1007/s13340-021-00551-0.

Keywords: Bariatric surgery; Diabetes; Duodenojejunal bypass; Metabolic surgery; Obesity; Sleeve gastrectomy.

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Conflict of interest statement

Conflict of interestThe Joint Committee of Japanese Society for Treatment of Obesity, The Japan Diabetes Society, and Japan Society for the Obesity have received reports of conflicts of interest over the past three years based on the following criteria regarding the economic relationship between members or collaborators and companies. Conflict of interest disclosure items: If applicable, declare the specific company names (organization names). If not applicable, not indicated. (1) Whether or not a member or an advisor of the board of directors of a company or an organization for profit is appointed, and the amount of remuneration (1 million yen or more per year from one company or organization for profit). (2) Holding of stocks and profits from those stocks (if one company's annual profit is 1 million yen or more, or holding 5% or more of total issued stocks). (3) Patent royalties paid by companies or organizations for profit (one patent royalties is 1 million yen or more per year). (4) The value, lecture fees, etc. paid by companies or commercial organizations for the time and effort required for attending meetings (presentations, advice, etc.) or research (total fee from one company or organization for profit is 0.5 million yen or more per year). (5) Fee paid for writing, such as brochures paid by companies or organizations for profit (total fee from one company or organization for profit is 0.5 million yen or more per year). (6) The total amount of research funds that researchers can decide to apply by themselves for medical research such as joint research, contract research, clinical trials, etc. is 1 million yen or more per year from one company or organization for profit. (7) The total amount of donation for research that researchers can decide to apply provided by themselves for research fields/groups/departments is 1 million yen or more per year from one company or organization for profit. (8) If the researchers belong to a group/department with funding by a company donation, etc. (9) Receiving a favor such as private travel fee, gifts that are not directly related to research (total remuneration is 50,000 yen or more per year, from one company or organization). Akira Sasaki: (4) Covidien Japan Inc. (6) ONO PHARMACEUTICAL CO., LTD., AstraZeneca K.K., NOVARTIS PHARMA K.K., Otsuka Pharmaceutical Co. Ltd., TAIHO PHARMACEUTICAL CO., LTD., Chugai Pharmaceutical Co., Ltd., PPD-SNBL K.K. (7) Covidien Japan Inc., Kaken Pharmaceutical Co.,Ltd. Koutaro Yokote: (4) Astellas Pharma Inc., AstraZeneca K.K., MSD K.K., Kowa Pharmaceutical Co., Ltd., NIPPON BOEHRINGER INGELHEIM CO., LTD., ONO PHARMACEUTICAL CO., LTD., NOVO NORDISK PHARMA LTD, TAKEDA PHARMACEUTICAL COMPANY LIMITED, Sumitomo Dainippon Pharma Co., Ltd., NOVARTIS PHARMA K.K., Mitsubishi Tanabe Pharma Corporation, ELI LILLY JAPAN K.K., TAISHO PHARMACEUTICAL CO., LTD., Sanofi K.K., Janssen Pharmaceutical K.K., DAIICHI SANKYO CO., LTD (6) TAISHO PHARMACEUTICAL CO., LTD. (7) ONO PHARMACEUTICAL CO., LTD., TAKEDA PHARMACEUTICAL COMPANY LIMITED, MSD K.K., DAIICHI SANKYO CO., LTD, Mitsubishi Tanabe Pharma Corporation, Shionogi & Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., NIPPON BOEHRINGER INGELHEIM CO., LTD., TEIJIN PHARMA LIMITED, BAYER YAKUHIN, LTD., Astellas Pharma Inc., Kowa Company, Ltd., NOVO NORDISK PHARMA LTD, TAISHO PHARMACEUTICAL CO., LTD. Takeshi Naitoh: (4) Johnson & Johnson K.K,Covidien Japan Inc.,Sumitomo Bakelite Co., Ltd.,Terumo Corporation,MSD K.K. (7) Chugai Pharmaceutical Co., Ltd. TAIHO PHARMACEUTICAL CO., LTD.,Covidien Japan Inc. Junji Fujikura: None to disclose. Karin Hayashi: None to disclose. Yushi Hirota: (4) ELI LILLY JAPAN K.K., Sanofi K.K. Nobuya Inagaki: (4) Kowa Pharmaceutical Co., Ltd., MSD K.K., Astellas Pharma Inc., NOVO NORDISK PHARMA LTD, ONO PHARMACEUTICAL CO., LTD., NIPPON BOEHRINGER INGELHEIM CO., LTD., TAKEDA PHARMACEUTICAL COMPANY LIMITED, Mitsubishi Tanabe Pharma Corporation, Sumitomo Dainippon Pharma Co., Ltd., Sanofi K.K., ELI LILLY JAPAN K.K. (6) Terumo Corporation, Drawbridge Inc, asken. (7) TAKEDA PHARMACEUTICAL COMPANY LIMITED, MSD K.K., ONO PHARMACEUTICAL CO., LTD., Mitsubishi Tanabe Pharma Corporation, KISSEI PHARMACEUTICAL CO., LTD, Sanofi K.K., DAIICHI SANKYO CO., LTD, Japan Tobacco Inc., Kyowa Kirin Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Astellas Pharma Inc., SANWA KAGAKU KENKYUSHO, Nippon Boehringer Ingelheim Co., Ltd., Novo Nordisk Pharma Ltd., Novartis Pharma K.K., Life Scan Japan (8).TAKEDA PHARMACEUTICAL COMPANY LIMITED, MSD K.K., ONO PHARMACEUTICAL CO., LTD., Mitsubishi Tanabe Pharma Corporation. Yasushi Ishigaki: (4) MSD K.K., NOVO NORDISK PHARMA LTD, Sanofi K.K., TAKEDA PHARMACEUTICAL COMPANY LIMITED, ONO PHARMACEUTICAL CO., LTD., NOVARTIS PHARMA K.K., Kowa Pharmaceutical Co., Ltd., BAYER YAKUHIN, LTD. (6) DAIICHI SANKYO CO., LTD, TAKEDA Science Foundation (7) ONO PHARMACEUTICAL CO., LTD., MSD K.K. Kazunori Kasama: (4) Johnson & Johnson K.K., Covidien Japan Inc. (6) Covidien Japan Inc., Nikkiso Co., Ltd. Eri Kikkawa: None to disclose. Hidenori Koyama: None to disclose. Hiroaki Masuzaki: None to disclose. Takeshi Miyatsuka: (8) MSD K.K., Mitsubishi Tanabe Pharma Corporation, Nippon Boehringer Ingelheim Co., Ltd., ONO PHARMACEUTICAL CO., LTD., Kowa Company, Ltd. Takehiro Nozaki: None to disclose. Wataru Ogawa: (4) Sumitomo Dainippon Pharma Co., Ltd., NOVARTIS PHARMA K.K., Nippon Boehringer Ingelheim Co., Ltd., TAKEDA PHARMACEUTICAL COMPANY LIMITED, Mitsubishi Tanabe Pharma Corporation, Abbott Japan LLC. (6) Noster,Nippon, Boehringer Ingelheim Co., Ltd., Boehringer Ingelheim Pharma GmbH&Co.KG, ELI LILLY JAPAN K.K., NOVO NORDISK PHARMA LTD, Abbott Japan LLC., Abbott Diabetes Care UK Ltd, Sumitomo Dainippon Pharma Co., Ltd. (7) Kowa Company, Ltd., NOVO NORDISK PHARMA LTD, Astellas Pharma Inc., Sumitomo Dainippon Pharma Co., Ltd., ONO PHARMACEUTICAL CO., LTD., TAKEDA PHARMACEUTICAL COMPANY LIMITED, Abbott Japan LLC., NOVARTIS PHARMA K.K., DAIICHI SANKYO CO., LTD, ELI LILLY JAPAN K.K., Mitsubishi Tanabe Pharma Corporation, Nippon Boehringer Ingelheim Co., Ltd. Masayuki Ohta: None to disclose. Shinichi Okazumi: None to disclose. Michio Shimabukuro: (4) Kowa Company, Ltd., NIPPON BOEHRINGER INGELHEIM CO., LTD., Sanofi K.K., SANWA KAGAKU KENKYUSHO, TAKEDA PHARMACEUTICAL COMPANY LIMITED, ELI LILLY JAPAN K.K., Mitsubishi Tanabe Pharma Corporation, MSD K.K., NOVO NORDISK PHARMA LTD, Astellas Pharma Inc., NOVARTIS PHARMA K.K., DAIICHI SANKYO CO., LTD. Iichiro Shimomura: (4) MSD K.K., ONO PHARMACEUTICAL CO., LTD., Kowa Company, Ltd., TAISHO PHARMACEUTICAL CO., LTD., TAKEDA PHARMACEUTICAL COMPANY LIMITED, ELI LILLY JAPAN K.K., NOVO NORDISK PHARMA LTD. (6) Kowa Company, Ltd., Kobayashi Pharmaceutical Co., Ltd., ROHTO Pharmaceutical Co.,Ltd. (7)Kyowa Kirin Co., Ltd., Kowa Company, Ltd., Sanofi K.K., DAIICHI SANKYO CO., LTD, Sumitomo Dainippon Pharma Co., Ltd., TAKEDA PHARMACEUTICAL COMPANY LIMITED, Mitsubishi Tanabe Pharma Corporation, TEIJIN PHARMA LIMITED, Novo Nordisk Pharma Ltd., MOCHIDA PHARMACEUTICAL CO., LTD. Hitoshi Nishizawa: None to disclose. Atsuhito Saiki: None to disclose. Yosuke Seki: (4) Johnson & Johnson K.K, Covidien Japan Inc. (6) Covidien Japan Inc., Nikkiso Co., Ltd, Sunny Health Co.,Ltd., Daiwa Securities Health Foundation. Nobuhiro Shojima: None to disclose. Motoyoshi Tsujino: None to disclose. Satoshi Ugi: None to disclose. Hirotaka Watada: (4) Mitsubishi Tanabe Pharma Corporation, Sumitomo Dainippon Pharma Co., Ltd., SANWA KAGAKU KENKYUSHO, TAKEDA PHARMACEUTICAL COMPANY LIMITED, Sanofi K.K., Kowa Company, Ltd., MSD K.K., Nippon Boehringer Ingelheim Co., Ltd., Eli Lilly Japan K.K., Novo Nordisk Pharma Ltd., AstraZeneca K.K., ONO PHARMACEUTICAL CO., LTD., Astellas Pharma Inc., Kyowa Kirin Co., Ltd., Terumo Corporation. (6) Sanofi K.K., Kowa Company, Ltd., Nippon Boehringer Ingelheim Co., Ltd., Yakult Honsha Co.,Ltd. (7) TAKEDA PHARMACEUTICAL COMPANY LIMITED, NIPPON BOEHRINGER INGELHEIM CO., LTD., KISSEI PHARMACEUTICAL CO., LTD, NOVO NORDISK PHARMA LTD, Mitsubishi Tanabe Pharma Corporation, LifeScan Japan, Kyowa Kirin Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., TAISHO PHARMACEUTICAL CO., LTD., Abbott Japan LLC., DAIICHI SANKYO CO., LTD, Astellas Pharma Inc., ONO PHARMACEUTICAL CO., LTD., TEIJIN PHARMA LIMITED, Sanofi K.K., MSD K.K., Pfizer Japan Inc. (8)TAKEDA PHARMACEUTICAL COMPANY LIMITED, Soiken Inc., SANWA KAGAKU KENKYUSHO, Sumitomo Dainippon Pharma Co., Ltd., TAISHO PHARMACEUTICAL CO., LTD., Mitsubishi Tanabe Pharma Corporation, ONO PHARMACEUTICAL CO., LTD., Kowa Pharmaceutical Co., Ltd., MSD K.K.,Nippon Boehringer Ingelheim Co., Ltd. Toshimasa Yamauchi: (4) Astellas Pharma Inc., AstraZeneca K.K., ONO PHARMACEUTICAL CO., LTD., Sanofi K.K., TAKEDA PHARMACEUTICAL COMPANY LIMITED, DAIICHI SANKYO CO., LTD, NOVARTIS PHARMA K.K., NOVO NORDISK PHARMA LTD. (6) AstraZeneca K.K., Kowa Company, Ltd., MSD K.K., DAIICHI SANKYO CO., LTD, Sanofi K.K., NIPPON BOEHRINGER INGELHEIM CO., LTD., Aero Switch,SANWA KAGAKU KENKYUSHO, Minophagen Pharmaceutical Co., LTD., Mitsubishi Corporation Life Sciences Limited., NIPRO CORPORATION. (7) NOVO NORDISK PHARMA LTD, Mitsubishi Tanabe Pharma Corporation, TAISHO PHARMACEUTICAL CO., LTD., KISSEI PHARMACEUTICAL CO., LTD, Kyowa Kirin Co., Ltd., DAIICHI SANKYO CO., LTD. (8) TAKEDA PHARMACEUTICAL COMPANY LIMITED, ONO PHARMACEUTICAL CO., LTD., NOVO NORDISK PHARMA LTD, Mitsubishi Tanabe Pharma Corporation, MSD K.K., NIPPON BOEHRINGER INGELHEIM CO., LTD., Kowa Company, Ltd., Asahi Mutual Life Insurance Company.Takashi Yamaguchi: None to disclose. Ichiro Tatsuno: (4) NOVARTIS PHARMA K.K., TAKEDA PHARMACEUTICAL COMPANY LIMITED. (7) BAYER YAKUHIN, LTD., TAKEDA PHARMACEUTICAL COMPANY LIMITED, ONO PHARMACEUTICAL CO., LTD. Kojiro Ueki: (4) Sumitomo Dainippon Pharma Co, Ltd., MSD K.K., Kyowa Kirin Co., Ltd., DAIICHI SANKYO CO.,LTD., NIPPON BOEHRINGER INGELHEIM CO.,LTD., TAKEDA PHARMACEUTICAL COMPANY LIMITED, NOVO NORDISK PHARMA LTD, Mitsubishi Tanabe Pharma Corporation, AstraZeneca K.K., ONO PHARMACEUTICAL CO., LTD., Sanofi K.K., Astellas Pharma Inc. (6) Astellas Pharma Inc., NOVO NORDISK PHARMA LTD., ELI LILLY JAPAN K.K., NIPPON BOEHRINGER INGELHEIM CO., LTD., Abbott Japan LLC., MSD K.K. (7) Sanofi K.K., NIPPON BOEHRINGER INGELHEIM CO., LTD., NOVO NORDISK PHARMA LTD, Sumitomo Dainippon Pharma Co., Ltd., Kyowa Kirin Co., Ltd., TAKEDA PHARMACEUTICAL COMPANY LIMITED, Mitsubishi Tanabe Pharma Corporation, Astellas Pharma Inc., DAIICHI SANKYO CO., LTD, ONO PHARMACEUTICAL CO., LTD. Takashi Kadowaki: (4) MSD K.K., Astellas Pharma Inc., AstraZeneca K.K., Abbott Japan LLC., Sanofi K.K., Terumo Corporation, NOVO NORDISK PHARMA LTD, ONO PHARMACEUTICAL CO., LTD., Mitsubishi Tanabe Pharma Corporation, ELI LILLY JAPAN K.K., NIPPON BOEHRINGER INGELHEIM CO., LTD., TAKEDA PHARMACEUTICAL COMPANY LIMITED, Sumitomo Dainippon Pharma Co., Ltd. (5)TAKEDA PHARMACEUTICAL COMPANY LIMITED. (6) AstraZeneca K.K., DAIICHI SANKYO CO., LTD, TAKEDA PHARMACEUTICAL COMPANY LIMITED. (7) Astellas Pharma Inc., KISSEI PHARMACEUTICAL CO., LTD, Sanofi K.K., NOVO NORDISK PHARMA LTD, ONO PHARMACEUTICAL CO., LTD., Taisho Pharma Co., Ltd., DAIICHI SANKYO CO., LTD, Mitsubishi Tanabe Pharma Corporation, TAKEDA PHARMACEUTICAL COMPANY LIMITED, Sumitomo Dainippon Pharma Co., Ltd. (8) MSD K.K., NOVO NORDISK PHARMA LTD, Kowa Pharmaceutical Co., Ltd, ONO PHARMACEUTICAL CO., LTD., Mitsubishi Tanabe Pharma Corporation, NIPPON BOEHRINGER INGELHEIM CO., LTD., TAKEDA PHARMACEUTICAL COMPANY LIMITED, Asahi Mutual Life Insurance Company.

Figures

**Fig. 1**
Diagnostic flowchart for obesity disease

**Fig. 3**
Psychological changes observed after metabolic surgery

See this image and copyright information in PMC

References

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Metabolic surgery in treatment of obese Japanese patients with type 2 diabetes: a joint consensus statement from the Japanese Society for Treatment of Obesity, the Japan Diabetes Society, and the Japan Society for the Study of Obesity

Affiliations

Metabolic surgery in treatment of obese Japanese patients with type 2 diabetes: a joint consensus statement from the Japanese Society for Treatment of Obesity, the Japan Diabetes Society, and the Japan Society for the Study of Obesity

Authors

Affiliations

Erratum in

Abstract

Conflict of interest statement

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References

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