Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Baratric Procedures

2019 Update

CLINICAL PRACTICE GUIDELINES FOR THE PERIOPERATIVE NUTRITION, METABOLIC, AND NONSURGICAL SUPPORT OF PATIENTS UNDERGOING BARIATRIC PROCEDURES Ð 2019 UPDATE: COSPONSORED BY AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS/AMERICAN COLLEGE OF ENDOCRINOLOGY, THE OBESITY SOCIETY, AMERICAN SOCIETY FOR METABOLIC & BARIATRIC SURGERY, OBESITY MEDICINE ASSOCIATION, AND AMERICAN SOCIETY OF ANESTHESIOLOGISTS

Obesity is an officially recognized global disease and continues to be a risk factor for chronic medical conditions such as cardiovascular diseases, diabetes, chronic kidney disease, nonalcoholic fatty liver disease, metabolic syndrome, and many cancers. This updated guideline is based on an increased number and quality of the best available scientific studies to guide physicians in the clinical care of patients with obesity who undergo surgical and nonsurgical bariatric procedures. This guideline identifies patient candidates for bariatric procedures, discusses which types of bariatric procedures should be offered, outlines management of patients before procedures, and recommends how to optimize patient care during and after procedures.

Since publication of the previous guideline in 2013, the role of bariatric surgery in the treatment of patients with type 2 diabetes has grown substantially. Studies have demonstrated that bariatric/metabolic surgery achieves superior improvements in glycemic control of patients with type 2 diabetes and obesity, compared with various medical and lifestyle interventions, and leads to substantial cost savings. Improved cardiovascular outcomes and quality of life have also been reported in patients undergoing bariatric surgery. New and emerging surgical and nonsurgical bariatric procedures are described. Criteria for bariatric procedures are better defined.

This update includes checklists to assist health-care professionals achieve greater precision in clinical decision-making and discusses the importance of a team approach to patient care, with special attention on nutrition, metabolism, and interventions to improve recovery after bariatric surgery. Enhanced recovery after bariatric surgery procedures are discussed in detail. Bariatric procedures remain a safe and effective intervention for higher-risk patients with obesity.

For the full update visit: https://journals.aace.com/doi/pdf/10.4158/GL-2019-0406