Global Variations in Practices After Bariatric and Metabolic Surgery; the PARTNER study

  1. Danielle Clyde
  2. Callum Grant
  3. Juan Andres Aguiar Canales
  4. Reza Adib
  5. Sarfaraz Baig
  6. Aparna G. Bhasker
  7. David Cameron
  8. Copaescu Catalin
  9. Ken Clare
  10. Andrew de Beaux
  11. Gillian Drummond
  12. Hayssam Fawal
  13. Martin Fried
  14. Yitka Graham
  15. Ramen Goel
  16. Kasey Goodpaster
  17. Eric Hazebroek
  18. George Hopkins
  19. Farah Husain
  20. Anita Jatana
  21. Brian Joyce
  22. Mohammad Kermansaravi
  23. Shanu Kothari
  24. Lillian Kow
  25. Silvia Leite
  26. Brij Madhok
  27. David Mahon
  28. Karl Miller
  29. Alex Miras
  30. Violeta Moize
  31. Manoel G Neto
  32. Abdelrahman Nimeri
  33. Mary O'Kane
  34. Ralph Peterli
  35. Luis Poggi
  36. Denise Ratcliffe
  37. Nasser Sakran
  38. Paulina Salminen
  39. Rupa Sarkar
  40. Jon Shenfine
  41. Rishi Singhal
  42. Stephanie Sogg
  43. Erik Stenberg
  44. Michel Suter
  45. Safwan Taha
  46. Abd Tahrani
  47. Ramon Vilallonga
  48. Kelvin Voon
  49. Richard Welbourn
  50. Carlos Zerrweck
  51. Osama Moussa
  52. James Byrne
  53. Peter Lamb
  54. Chetan Parmar
  55. Omar Ghanem
  56. Kamal K. Mahawar
  57. Andrew G. N. Robertson
  58. Wah Yang
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Abstract

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.

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