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. 2025 Jun 28.
doi: 10.1007/s13304-025-02304-z. Online ahead of print.

SICOB Italian Clinical Practice GRADE-based guidelines for the endobariatric treatment of overweight, obesity, and obesity-associated diseases

Maurizio De Luca  1 , Amanda Belluzzi  1 , Monica Zese  1 , Andrea Anderloni  2 , Rosario Bellini  3 , Rossana Daniela Berta  4 , Ivo Boskoski  5 , Maria Grazia Carbonelli  6 , Rita Cataldo  7 , Maria Rosaria Cerbone  8 , Marco Chianelli  9 , Rita Conigliaro  10 , Carla Micaela Cuttica  11 , Corrado De Martino  12 , Carla Destro  1 , Carlo De Werra  13 , Nicola Di Lorenzo  14 , Massimo Di Simone  15 , Ludovico Docimo  16 , Enrico Facchiano  17 , Mirto Foletto  18 , Pietro Forestieri  19 , Diego Foschi  20 , Giuseppe Gagliardi  21 , Giovanni Galasso  22 , Giuseppe Galloro  23 , Paolo Gentileschi  24 , Ilenia Grandone  25 , Arianna Goracci  26 , Francesca Clemente Gregoris  27 , Valentina Lorenzoni  28 , Raffaele Manta  29 , Mario Musella  30 , Paolo Marzullo  31 , Gerardo Medea  32 , Giuseppe Navarra  33 , Monica Ortenzi  34 , Barbara Paolini  35 , Emanuela Paone  36 , Luigi Piazza  37 , Vincenzo Pilone  38 , Debora Porri  39 , Marco Raffaelli  40 , Farnaz Rahimi  41 , Andrea Rizzi  42 , Simone Rugolotto  43 , Giuliano Sarro  20 , Caterina Scalamogna  43 , Andrea Sanna  1 , Giovanni Sarnelli  44 , Luca Sessa  45 , Simone Targa  1 , Iris Zani  46 , Benedetta Ragghianti  47 , Giulia Bandini  47 , Anna Lo Cricchio  47 , Antonio Silverii  47 , Marco Antonio Zappa  48 , Monami Matteo  49
Affiliations

SICOB Italian Clinical Practice GRADE-based guidelines for the endobariatric treatment of overweight, obesity, and obesity-associated diseases

Maurizio De Luca et al. Updates Surg. .

Abstract

Obesity is a chronic disease associated with increased morbidity and mortality and reduced quality of life. Pharmacotherapy can be associated with life style interventions aiming at increasing and maintaining weight loss and ameliorating obesity-related medical conditions. In patients affected by obesity and uncontrolled obesity-associated complications or high degree of BMI (> 40 kg/m2), metabolic bariatric surgery (MBS) can be a feasible therapeutic option. Many different types of surgical procedures have been developed in last decades, mainly performed via laparoscopic approaches. However, clinical indications for MBS and the selection of the most appropriate type of procedure have not been clarified so far. The Italian Society of Bariatric and Metabolic Surgery for Obesity (Società Italiana di Chirurgia dell'Obesità e delle Malattie Metaboliche-SICOB) decided to design and develop the updated version of the Italian guidelines aimed at assisting healthcare professionals in the choice of the surgical option for the treatment of obesity and related medical conditions. Between June and October 2022, a panel of 24 experts and an evidence review team (ERT, 10 members), participated in the definition of clinical questions, outcomes, and recommendations and collected and analyzed all the available evidence on the basis of pre-specified search strategies. GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology and PICO (Patient, Intervention, Comparison, Outcome) conceptual framework have been adopted for the development of the present guidelines. The aim of the present guideline is to verify indications to bariatric surgical endoscopy with respect to the presence of comorbid conditions, evaluate the different types of endoscopic bariatric procedure and revise indication to revisional bariatric endoscopy and postoperative procedures.

Keywords: GRADE methodology; Guidelines; Obesity management.

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Conflict of interest statement

Declarations. Conflict of interest: All panel members and members of the Evidence Review Team (ERT) completed the conflict of interest disclosure form developed by the CNEC. Below is a summary of the declarations made by individual members. For further details please see the Supplementary Materials.

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