Current recommendations for procedure selection in class I and II obesity developed by an expert modified Delphi consensus
Abstract Metabolic and bariatric surgery (MBS) is widely considered the most effective option for treating obesity, a chronic, relapsing, and progressive disease. Recently, the American Society of Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and...
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| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2024-02-01
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| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-024-54141-6 |
| _version_ | 1797275237375541248 |
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| author | Mohammad Kermansaravi Sonja Chiappetta Chetan Parmar Scott A. Shikora Gerhard Prager Teresa LaMasters Jaime Ponce Lilian Kow Abdelrahman Nimeri Shanu N. Kothari Edo Aarts Syed Imran Abbas Ahmad Aly Ali Aminian Ahmad Bashir Estuardo Behrens Helmuth Billy Miguel A. Carbajo Benjamin Clapp Jean-Marc Chevallier Ricardo V. Cohen Jerome Dargent Bruno Dillemans Silvia L. Faria Manoel Galvao Neto Pierre Y. Garneau Khaled Gawdat Ashraf Haddad Mohamad Hayssam ElFawal Kelvin Higa Jaques Himpens Farah Husain Matthew M. Hutter Kazunori Kasama Radwan Kassir Amir Khan Mousa Khoursheed Matthew Kroh Marina S. Kurian Wei-Jei Lee Ken Loi Kamal Mahawar Corrigan L. McBride Hazem Almomani John Melissas Karl Miller Monali Misra Mario Musella C. Joe Northup Mary O’Kane Pavlos K. Papasavas Mariano Palermo Richard M. Peterson Ralph Peterli Luis Poggi Janey S. A. Pratt Aayad Alqahtani Almino C. Ramos Karl Rheinwalt Rui Ribeiro Ann M. Rogers Bassem Safadi Paulina Salminen Sergio Santoro Nathaniel Sann John D. Scott Asim Shabbir Stephanie Sogg Erik Stenberg Michel Suter Antonio Torres Surendra Ugale Ramon Vilallonga Cunchuan Wang Rudolf Weiner Natan Zundel Luigi Angrisani Maurizio De Luca |
| author_facet | Mohammad Kermansaravi Sonja Chiappetta Chetan Parmar Scott A. Shikora Gerhard Prager Teresa LaMasters Jaime Ponce Lilian Kow Abdelrahman Nimeri Shanu N. Kothari Edo Aarts Syed Imran Abbas Ahmad Aly Ali Aminian Ahmad Bashir Estuardo Behrens Helmuth Billy Miguel A. Carbajo Benjamin Clapp Jean-Marc Chevallier Ricardo V. Cohen Jerome Dargent Bruno Dillemans Silvia L. Faria Manoel Galvao Neto Pierre Y. Garneau Khaled Gawdat Ashraf Haddad Mohamad Hayssam ElFawal Kelvin Higa Jaques Himpens Farah Husain Matthew M. Hutter Kazunori Kasama Radwan Kassir Amir Khan Mousa Khoursheed Matthew Kroh Marina S. Kurian Wei-Jei Lee Ken Loi Kamal Mahawar Corrigan L. McBride Hazem Almomani John Melissas Karl Miller Monali Misra Mario Musella C. Joe Northup Mary O’Kane Pavlos K. Papasavas Mariano Palermo Richard M. Peterson Ralph Peterli Luis Poggi Janey S. A. Pratt Aayad Alqahtani Almino C. Ramos Karl Rheinwalt Rui Ribeiro Ann M. Rogers Bassem Safadi Paulina Salminen Sergio Santoro Nathaniel Sann John D. Scott Asim Shabbir Stephanie Sogg Erik Stenberg Michel Suter Antonio Torres Surendra Ugale Ramon Vilallonga Cunchuan Wang Rudolf Weiner Natan Zundel Luigi Angrisani Maurizio De Luca |
| author_sort | Mohammad Kermansaravi |
| collection | DOAJ |
| description | Abstract Metabolic and bariatric surgery (MBS) is widely considered the most effective option for treating obesity, a chronic, relapsing, and progressive disease. Recently, the American Society of Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) issued new guidelines on the indications for MBS, which have superseded the previous 1991 National Institutes of Health guidelines. The aim of this study is to establish the first set of consensus guidelines for selecting procedures in Class I and II obesity, using an Expert Modified Delphi Method. In this study, 78 experienced bariatric surgeons from 32 countries participated in a two-round Modified Delphi consensus voting process. The threshold for consensus was set at an agreement or disagreement of ≥ 70.0% among the experts. The experts reached a consensus on 54 statements. The committee of experts reached a consensus that MBS is a cost-effective treatment option for Class II obesity and for patients with Class I obesity who have not achieved significant weight loss through non-surgical methods. MBS was also considered suitable for patients with Type 2 diabetes mellitus (T2DM) and a body mass index (BMI) of 30 kg/m2 or higher. The committee identified intra-gastric balloon (IGB) as a treatment option for patients with class I obesity and endoscopic sleeve gastroplasty (ESG) as an option for patients with class I and II obesity, as well as for patients with T2DM and a BMI of ≥ 30 kg/m2. Sleeve gastrectomy (1) and Roux-en-Y gastric bypass (RYGB) were also recognized as viable treatment options for these patient groups. The committee also agreed that one anastomosis gastric bypass (OAGB) is a suitable option for patients with Class II obesity and T2DM, regardless of the presence or severity of obesity-related medical problems. The recommendations for selecting procedures in Class I and II obesity, developed through an Expert Modified Delphi Consensus, suggest that the use of standard primary bariatric endoscopic (IGB, ESG) and surgical procedures (SG, RYGB, OAGB) are acceptable in these patient groups, as consensus was reached regarding these procedures. However, randomized controlled trials are still needed in Class I and II Obesity to identify the best treatment approach for these patients in the future. |
| first_indexed | 2024-03-07T15:10:31Z |
| format | Article |
| id | doaj.art-d11a127484f24f42a7a29a6327c26a74 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-07T15:10:31Z |
| publishDate | 2024-02-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-d11a127484f24f42a7a29a6327c26a742024-03-05T18:40:53ZengNature PortfolioScientific Reports2045-23222024-02-0114111210.1038/s41598-024-54141-6Current recommendations for procedure selection in class I and II obesity developed by an expert modified Delphi consensusMohammad Kermansaravi0Sonja Chiappetta1Chetan Parmar2Scott A. Shikora3Gerhard Prager4Teresa LaMasters5Jaime Ponce6Lilian Kow7Abdelrahman Nimeri8Shanu N. Kothari9Edo Aarts10Syed Imran Abbas11Ahmad Aly12Ali Aminian13Ahmad Bashir14Estuardo Behrens15Helmuth Billy16Miguel A. Carbajo17Benjamin Clapp18Jean-Marc Chevallier19Ricardo V. Cohen20Jerome Dargent21Bruno Dillemans22Silvia L. Faria23Manoel Galvao Neto24Pierre Y. Garneau25Khaled Gawdat26Ashraf Haddad27Mohamad Hayssam ElFawal28Kelvin Higa29Jaques Himpens30Farah Husain31Matthew M. Hutter32Kazunori Kasama33Radwan Kassir34Amir Khan35Mousa Khoursheed36Matthew Kroh37Marina S. Kurian38Wei-Jei Lee39Ken Loi40Kamal Mahawar41Corrigan L. McBride42Hazem Almomani43John Melissas44Karl Miller45Monali Misra46Mario Musella47C. Joe Northup48Mary O’Kane49Pavlos K. Papasavas50Mariano Palermo51Richard M. Peterson52Ralph Peterli53Luis Poggi54Janey S. A. Pratt55Aayad Alqahtani56Almino C. Ramos57Karl Rheinwalt58Rui Ribeiro59Ann M. Rogers60Bassem Safadi61Paulina Salminen62Sergio Santoro63Nathaniel Sann64John D. Scott65Asim Shabbir66Stephanie Sogg67Erik Stenberg68Michel Suter69Antonio Torres70Surendra Ugale71Ramon Vilallonga72Cunchuan Wang73Rudolf Weiner74Natan Zundel75Luigi Angrisani76Maurizio De Luca77Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat-e Fatemeh Hospital, Iran University of Medical SciencesDepartment of General and Laparoscopic Surgery, Obesity and Metabolic Surgery Unit, Ospedale Evangelico BetaniaWhittington HospitalDepartment of Surgery, Center for Metabolic and Bariatric Surgery, Brigham and Women’s Hospital, and Harvard Medical SchoolMedical University of ViennaUnitypoint Clinic Weight Loss SpecialistsBariatric Surgery Program, CHI Memorial HospitalAdelaide Bariatric Centre, Flinders University of South AustraliaDepartment of Surgery, Center for Metabolic and Bariatric Surgery, Brigham and Women’s Hospital, and Harvard Medical SchoolPrisma Health, Department of Surgery, University of South Carolina School of MedicineWeightWorks Clinics and Allurion ClinicsIranian HospitalAustin and Repatriation Medical Centre, University of MelbourneDepartment of General Surgery, Bariatric and Metabolic Institute, Cleveland ClinicMinimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan HospitalNew Life CenterVentura Advanced Surgical AssociatesCentre of Excellence for the Study and Treatment of Obesity and DiabetesDepartment of Surgery, Texas Tech HSC Paul Foster School of MedicineUniversité Paris 5Center for the Treatment of Obesity and Diabetes, Hospital Alemão Oswaldo CruzPolyclinique Lyon NordDepartment of General Surgery, AZ Sint Jan Brugge-OostendeGastrocirurgia de Brasilia, University of BrasiliaEndovitta InstituteDivision of Bariatric Surgery, CIUSSS-NIMBariatric Surgery Unit, Faculty of Medicine, Ain Shams UniversityMinimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan HospitalMakassed General HospitalFresno Heart and Surgical Hospital, UCSF FresnoBariatric Surgery Unit, Delta Chirec HospitalUniversity of Arizona College of MedicineDepartment of Surgery, Massachusetts General HospitalWeight Loss and Metabolic Surgery Center, Yotsuya Medical CubeDepartment of Digestive Surgery, CHU Félix GuyonWalsall Healthcare NHS TrustTaiba HospitalDigestive Disease and Surgery Institute, Cleveland ClinicDepartment of Surgery, New York University Grossman School of MedicineMedical Weight Loss Center, China Medical University Shinchu HospitalDirector of St George SurgerySouth Tyneside and Sunderland Foundation NHS TrustUniversity of Nebraska Medical CenterNMC Royal HospitalBariatric Unit, Heraklion University Hospital, University of CreteDiakonissen Wehrle Private HospitalCedars Sinai Medical CenterAdvanced Biomedical Sciences Department, Federico II” UniversityBMI SurgeryDepartment of Nutrition and Dietetics, Leeds Teaching Hospitals, NHS TrustDivision of Metabolic and Bariatric Surgery, Hartford HospitalDepartment of Surgery, Centro CIEN-Diagnomed, University of Buenos AiresDepartment of General and Minimally Invasive Surgery, UT Health San AntonioDepartment of Visceral Surgery, Clarunis, University Digestive Health Care Center, St. Clara Hospital and University Hospital BaselDepartment of Surgery Clinica Anglo Americana, Universidad Nacional Mayor de San MarcosDepartment of Surgery, Stanford School of Medicine, VA Palo Alto Health Care SystemNew You Medical Center, King Saud University, Obesity ChairMedical Director of Gastro-Obeso-Center, Institute for Metabolic OptimizationDepartment of Bariatric, Metabolic, and Plastic Surgery, St. Franziskus HospitalCentro Multidisciplinar Do Tratamento da Obesidade, Hospital Lusíadas Amadora e LisbonDepartment of Surgery - Division of Minimally Invasive and Bariatric Surgery, Penn State Health Milton S. Hershey Medical CenterAman HospitalDivision of Digestive Surgery and Urology, Department of Digestive Surgery, Turku University HospitalHospital Israelita Albert EinsteinAdvanced Surgical Partners of VirginiaDivision of Bariatric and Minimal Access Surgery, Department of Surgery, University of South Carolina School of MedicineNational University of SingaporeMassachusetts General Hospital Weight CenterDepartment of Surgery, Faculty of Medicine and Health, Örebro UniversityDepartment of Surgery, Riviera-Chablais HospitalDepartment of Surgery, Hospital Clínico San Carlos, Complutense University of MadridKirloskar and Virinchi HospitalsEndocrine, Bariatric, and Metabolic Surgery Department, Universitary Hospital Vall HebronDepartment of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan UniversityBariatric Surgery Unit, Sana Clinic OffenbachDepartment of Surgery, University of BuffaloDepartment of Public Health, Federico II University of NaplesDepartment of General Surgery Rovigo HospitalAbstract Metabolic and bariatric surgery (MBS) is widely considered the most effective option for treating obesity, a chronic, relapsing, and progressive disease. Recently, the American Society of Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) issued new guidelines on the indications for MBS, which have superseded the previous 1991 National Institutes of Health guidelines. The aim of this study is to establish the first set of consensus guidelines for selecting procedures in Class I and II obesity, using an Expert Modified Delphi Method. In this study, 78 experienced bariatric surgeons from 32 countries participated in a two-round Modified Delphi consensus voting process. The threshold for consensus was set at an agreement or disagreement of ≥ 70.0% among the experts. The experts reached a consensus on 54 statements. The committee of experts reached a consensus that MBS is a cost-effective treatment option for Class II obesity and for patients with Class I obesity who have not achieved significant weight loss through non-surgical methods. MBS was also considered suitable for patients with Type 2 diabetes mellitus (T2DM) and a body mass index (BMI) of 30 kg/m2 or higher. The committee identified intra-gastric balloon (IGB) as a treatment option for patients with class I obesity and endoscopic sleeve gastroplasty (ESG) as an option for patients with class I and II obesity, as well as for patients with T2DM and a BMI of ≥ 30 kg/m2. Sleeve gastrectomy (1) and Roux-en-Y gastric bypass (RYGB) were also recognized as viable treatment options for these patient groups. The committee also agreed that one anastomosis gastric bypass (OAGB) is a suitable option for patients with Class II obesity and T2DM, regardless of the presence or severity of obesity-related medical problems. The recommendations for selecting procedures in Class I and II obesity, developed through an Expert Modified Delphi Consensus, suggest that the use of standard primary bariatric endoscopic (IGB, ESG) and surgical procedures (SG, RYGB, OAGB) are acceptable in these patient groups, as consensus was reached regarding these procedures. However, randomized controlled trials are still needed in Class I and II Obesity to identify the best treatment approach for these patients in the future.https://doi.org/10.1038/s41598-024-54141-6Procedure selectionConsensusMetabolic surgeryBariatric surgeryClass I and II obesity |
| spellingShingle | Mohammad Kermansaravi Sonja Chiappetta Chetan Parmar Scott A. Shikora Gerhard Prager Teresa LaMasters Jaime Ponce Lilian Kow Abdelrahman Nimeri Shanu N. Kothari Edo Aarts Syed Imran Abbas Ahmad Aly Ali Aminian Ahmad Bashir Estuardo Behrens Helmuth Billy Miguel A. Carbajo Benjamin Clapp Jean-Marc Chevallier Ricardo V. Cohen Jerome Dargent Bruno Dillemans Silvia L. Faria Manoel Galvao Neto Pierre Y. Garneau Khaled Gawdat Ashraf Haddad Mohamad Hayssam ElFawal Kelvin Higa Jaques Himpens Farah Husain Matthew M. Hutter Kazunori Kasama Radwan Kassir Amir Khan Mousa Khoursheed Matthew Kroh Marina S. Kurian Wei-Jei Lee Ken Loi Kamal Mahawar Corrigan L. McBride Hazem Almomani John Melissas Karl Miller Monali Misra Mario Musella C. Joe Northup Mary O’Kane Pavlos K. Papasavas Mariano Palermo Richard M. Peterson Ralph Peterli Luis Poggi Janey S. A. Pratt Aayad Alqahtani Almino C. Ramos Karl Rheinwalt Rui Ribeiro Ann M. Rogers Bassem Safadi Paulina Salminen Sergio Santoro Nathaniel Sann John D. Scott Asim Shabbir Stephanie Sogg Erik Stenberg Michel Suter Antonio Torres Surendra Ugale Ramon Vilallonga Cunchuan Wang Rudolf Weiner Natan Zundel Luigi Angrisani Maurizio De Luca Current recommendations for procedure selection in class I and II obesity developed by an expert modified Delphi consensus Scientific Reports Procedure selection Consensus Metabolic surgery Bariatric surgery Class I and II obesity |
| title | Current recommendations for procedure selection in class I and II obesity developed by an expert modified Delphi consensus |
| title_full | Current recommendations for procedure selection in class I and II obesity developed by an expert modified Delphi consensus |
| title_fullStr | Current recommendations for procedure selection in class I and II obesity developed by an expert modified Delphi consensus |
| title_full_unstemmed | Current recommendations for procedure selection in class I and II obesity developed by an expert modified Delphi consensus |
| title_short | Current recommendations for procedure selection in class I and II obesity developed by an expert modified Delphi consensus |
| title_sort | current recommendations for procedure selection in class i and ii obesity developed by an expert modified delphi consensus |
| topic | Procedure selection Consensus Metabolic surgery Bariatric surgery Class I and II obesity |
| url | https://doi.org/10.1038/s41598-024-54141-6 |
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