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. 2023 Feb 10;28(1):5.
doi: 10.1007/s40519-023-01537-4.

SICOB-endorsed national Delphi consensus on obesity treatment optimization: focus on diagnosis, pre-operative management, and weight regain/insufficient weight loss approach

Marco Antonio Zappa #  1 , Angelo Iossa #  2 , Luca Busetto  3 , Sonja Chiappetta  4 , Francesco Greco  5 , Marcello Lucchese  6 , Fausta Micanti  7 , Geltrude Mingrone  8   9   10 , Giuseppe Navarra  11 , Marco Raffaelli  12 ; Delphi Expert Panel; Maurizio De Luca  13
Collaborators, Affiliations

SICOB-endorsed national Delphi consensus on obesity treatment optimization: focus on diagnosis, pre-operative management, and weight regain/insufficient weight loss approach

Marco Antonio Zappa et al. Eat Weight Disord. .

Abstract

Purpose: Overweight and obesity affects 60% of adults causing more than 1.2 million deaths across world every year. Fight against involved different specialist figures and multiple are the approved weapons. Aim of the present survey endorsed by the Italian Society of Bariatric Surgery (SICOB) is to reach a national consensus on obesity treatment optimization through a Delphi process.

Methods: Eleven key opinion leaders (KOLs) identified 22 statements with a major need of clarification and debate. The explored pathways were: (1) Management of patient candidate to bariatric/metabolic surgery (BMS); (2) Management of patient not eligible for BMS; (3) Management of patient with short-term (2 years) weight regain (WR) or insufficient weight loss (IWL); (4) Management of the patient with medium-term (5 years) WR; and (5) Association between drugs and BMS as WR prevention. The questionnaire was distributed to 65 national experts via an online platform with anonymized results.

Results: 54 out of 65 invited panelists (83%) respond. Positive consensus was reached for 18/22 statements (82%); while, negative consensus (s20.4; s21.5) and no consensus (s11.5, s17) were reached for 2 statements, respectively (9%).

Conclusion: The Delphi results underline the importance of first-line interdisciplinary management, with large pre-treatment examination, and establish a common opinion on how to properly manage post-operative IWL/WR.

Level of evidence v: Report of expert committees.

Keywords: Insufficient weight loss approach; Italian Delphi consensus; Obesity pre-operative management; Obesity treatment; Weight regain approach.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
A, B, C: Delphi results on Area: Management of the patient candidate to BS(3–6 months before); In green statement reaching positive consensus
Fig. 1
Fig. 1
A, B, C: Delphi results on Area: Management of the patient candidate to BS(3–6 months before); In green statement reaching positive consensus
Fig. 1
Fig. 1
A, B, C: Delphi results on Area: Management of the patient candidate to BS(3–6 months before); In green statement reaching positive consensus
Fig. 2
Fig. 2
A, B: Deplhi results on Area: Management of the patient not eligible for bariatric surgery In green statement reaching positive consensus, in yellow statement without consensus
Fig. 2
Fig. 2
A, B: Deplhi results on Area: Management of the patient not eligible for bariatric surgery In green statement reaching positive consensus, in yellow statement without consensus
Fig. 3
Fig. 3
Deplhi results on Area: Management of the patient who in the 2 years post-surgery did not respond to bariatric surgery (loss of insufficient weight—IWL) or reports weight regain (WR); In green statement reaching positive consensus, in red statement with negative consensus
Fig. 4
Fig. 4
Deplhi results on Area: Management of the patient who in the 5 years post bariatric surgery has a weight regain; In green statement reaching positive consensus, in red statement with negative consensus
Fig. 5
Fig. 5
Delphi results on Area: The pharmacological association in the post-operative period can improve the outcome of surgery; In green statement reaching positive consensus
See this image and copyright information in PMC

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