Global Variations in Practices after Bariatric and Metabolic Surgery; the PARTNER Study

Clyde D.; Grant C.; Canales J.A.A.; Adib R.; Baig S.; Bhasker A.G.; Cameron D.; Catalin C.; Clare K.; de Beaux A.; Drummond G.; Fawal H.; Fried M.; Graham Y.; Goel R.; Goodpaster K.; Hazebroek E.; Hopkins G.; Husain F.; Jatana A.; Joyce B.; Kermansaravi M.; Kothari S.; Kow L.; Leite S.; Madhok B.; Mahon D.; Miller K.; Miras A.; Moize V.; Neto M.G.; Nimeri A.; O’Kane M.; Peterli R.; Poggi L.; Ratcliffe D.; Sakran N.; Salminen P.; Sarkar R.; Shenfine J.; Singhal R.; Sogg S.; Stenberg E.; Suter M.; Taha S.; Tahrani A.; Vilallonga R.; Voon K.; Welbourn R.; Zerrweck C.; Moussa O.; Byrne J.; Lamb P.; Parmar C.; Ghanem O.; Mahawar K.K.; Robertson A.G.N.; Yang W. · Obesity Surgery (2025) · DOI: 10.1007/s11695-025-08356-9

Resumen

Background: With over 1 billion individuals affected globally, obesity and obesity related diseases is now a leading cause of death. Metabolic and bariatric surgery (MBS) has emerged as a cornerstone intervention for severe obesity and its associated comorbidities. Despite its efficacy, postoperative care and follow-up after MBS remains highly variable worldwide. Objective: The PARTNER study aimed to evaluate global clinical practices in the postoperative management following MBS by surveying multidisciplinary healthcare professionals. Methods: This study was an international online survey conducted between October 2024 and January 2025. A multidisciplinary team developed the questionnaire based on existing literature and international guidelines. The survey assessed five domains: follow-up care, postoperative treatment, dietary management, patient support, and measurement of surgical outcomes. Responses were analysed descriptively. Results: A total of 262 responses were received from 62 countries. Most respondents were bariatric surgeons (72.1%) working in public healthcare systems (73.3%). While 78.7% reported conducting three-month postoperative reviews, only 23.7% offered indefinite follow-up. Hybrid models of care (virtual and in-person) were common (56.9%). VTE prophylaxis and postoperative PPI use were recommended by 64.1% and 84.3% respectively. Nearly all respondents (98.1%) provided dietary advice, with protein and micronutrient supplementation widely endorsed. Only 56.1% routinely referred patients for psychological follow-up. Definitions of surgical success and failure varied widely, with inconsistent objective outcome measures. Conclusion: The PARTNER study reveals significant international variation in postoperative management practices following MBS. These findings underscore the need for more standardized, evidence-based guidelines to improve long-term outcomes and equity of care worldwide. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2025.