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Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures – 2019 Update: Cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic and Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists
Abstract
Objective: The development of these updated clinical practice guidelines (CPGs) was commissioned by the American Association of Clinical Endocrinologists (AACE), The Obesity Society (TOS), American Society for Metabolic and Bariatric Surgery (ASMBS), Obesity Medicine Association (OMA), and American Society of Anesthesiologists (ASA) Boards of Directors in adherence with the AACE 2017 protocol for standardized production of CPGs, algorithms, and checklists. Methods: Each recommendation was evaluated and updated based on new evidence from 2013 to the present and subjective factors provided by experts. Results: New or updated topics in this CPG include: contextualization in an adiposity‐based chronic disease complications‐centric model, nuance‐based and algorithm/checklist‐assisted clinical decision‐making about procedure selection, novel bariatric procedures, enhanced recovery after bariatric surgery protocols, and logistical concerns (including cost factors) in the current health care arena. There are 85 numbered recommendations that have updated supporting evidence, of which 61 are revised and 12 are new. Noting that there can be multiple recommendation statements within a single numbered recommendation, there are 31 (13%) Grade A, 42 (17%) Grade B, 72 (29%) Grade C, and 101 (41%) Grade D recommendations. There are 858 citations, of which 81 (9.4%) are evidence level (EL) 1 (highest), 562 (65.5%) are EL 2, 72 (8.4%) are EL 3, and 143 (16.7%) are EL 4 (lowest). Conclusions: Bariatric procedures remain a safe and effective intervention for higher‐risk patients with obesity. Clinical decision‐making should be evidence based within the context of a chronic disease. A team approach to perioperative care is mandatory, with special attention to nutritional and metabolic issues.
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Self-citationPirola, I., Formenti, A. M., Gandossi, E., Mittempergher, F., Casella, C., Agosti, B., & Cappelli, C. (2013) · Obesity Surgery · doi:10.1007/s11695-013-1015-y · Cited by 74
Cepeda-Lopez, A. C., Allende-Labastida, J., Melse-Boonstra, A., Osendarp, S. J., Herter-Aeberli, I., Moretti, D., Rodriguez-Lastra, R., Gonzalez-Salazar, F., Villalpando, S., & Zimmermann, M. B. (2016) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.115.115592 · Cited by 63
Improved Levothyroxine Pharmacokinetics After Bariatric Surgery
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Cited by
Rinella, M. E., Neuschwander-Tetri, B. A., Siddiqui, M. S., Abdelmalek, M. F., Caldwell, S., Barb, D., Kleiner, D. E., & Loomba, R. (2023) · Hepatology · doi:10.1097/hep.0000000000000323 · Cited by 2,667
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Self-citationApproach to Obesity Treatment in Primary Care: A Review
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Pureza, I. R. D. O. M., Macena, M. D. L., da Silva Junior, A. E., Praxedes, D. R. S., Vasconcelos, L. G. L., & Bueno, N. B. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2020.10.031 · Cited by 89
Pellegrini, M., Rahimi, F., Boschetti, S., Devecchi, A., De Francesco, A., Mancino, M. V., Toppino, M., Morino, M., Fanni, G., Ponzo, V., et al. (2021) · Journal of Endocrinological Investigation · doi:10.1007/s40618-020-01439-7 · Cited by 50
Metadata
- Authors
- Mechanick, J. I., Apovian, C., Brethauer, S., Timothy Garvey, W., Joffe, A. M., Kim, J., Kushner, R. F., Lindquist, R., Pessah‐Pollack, R., Seger, J., Urman, R. D., Adams, S., Cleek, J. B., Correa, R., Figaro, M. K., Flanders, K., Grams, J., Hurley, D. L., Kothari, S., Seger, M. V., & Still, C. D.
- Venue
- Obesity
- Publisher
- Wiley
- Published
- 2020-03-23
- Volume
- 28
- Issue
- 4
- Pages
- O1-O58
- ISSN
- 1930-7381 (ISSN-L)
- 1930-739X
- OpenAlex
- W3012746455
- Cited by
- 389
- References
- 102
- FWCI
- 35.53
- Type
- journal article
- Language
- en
- Open access
- closed
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.