SICOB-endorsed national Delphi consensus on obesity treatment optimization: focus on diagnosis, pre-operative management, and weight regain/insufficient weight loss approach

Marco Antonio Zappa, Angelo Iossa, Luca Busetto, Sonja Chiappetta, Francesco Greco, Marcello Lucchese, Fausta Micanti, Geltrude Mingrone, Giuseppe Navarra, Marco Raffaelli, Settimio Fabrizio Altorio, Luigi Angrisani, Claudio Arcudi, Fabrizio Bellini, Paolo Bernante, Rossana Berta, Esmeralda Capristo, Maria Grazia Carbonelli, Giovanni Casella, James Mariolo CasellaLidia Castagneto Gissey, Maria Rosaria Cerbone, Franco Ciampaglia, Luigi Ciccoritti, Alessandro Contine, Giuseppe Currò, Rosella D’Alessio, Massimiliano De Palma, Daniela Delle Piane, Nino Di Benedetto, Nicola Di Lorenzo, Giovanni Fantola, Rahimi Farnaz, Mirto Foletto, Pietro Forestieri, Lucia Frittitta, Elisa Galfrascoli, Paolo Gentileschi, Cristiano Giardiello, Piero Giustacchini, Maria Paola Giusti, Ilenia Grandone, Caterina Guidone, Amerigo Iaconelli, Erminia Lembo, Silvana Leanza, Erminia Lembo, Giovanni Lezoche, Cesare Lunardi, Gennaro Martines, Bernardo Marzano, Emanuela Paone, Francesco Saverio Papadia, Federico Perrone, Luigi Piazza, Vincenzo Pilone, Pietro Pizzi, Mark Rice, Andrea Rizzi, Ferruccio Santini, Giuliano Sarro, Angelo Schettino, Nicola Tartaglia, Mauro Toppino, Piero Maria Toppino, Antonella Usai, Alessandro Usai, Maurizio De Luca, Marianna De Luca

Research output: Contribution to journalArticle


Purpose: Overweight and obesity affects 60% of adults causing more than 1.2 million deaths across world every year. Fight against involved different specialist figures and multiple are the approved weapons. Aim of the present survey endorsed by the Italian Society of Bariatric Surgery (SICOB) is to reach a national consensus on obesity treatment optimization through a Delphi process. Methods: Eleven key opinion leaders (KOLs) identified 22 statements with a major need of clarification and debate. The explored pathways were: (1) Management of patient candidate to bariatric/metabolic surgery (BMS); (2) Management of patient not eligible for BMS; (3) Management of patient with short-term (2 years) weight regain (WR) or insufficient weight loss (IWL); (4) Management of the patient with medium-term (5 years) WR; and (5) Association between drugs and BMS as WR prevention. The questionnaire was distributed to 65 national experts via an online platform with anonymized results. Results: 54 out of 65 invited panelists (83%) respond. Positive consensus was reached for 18/22 statements (82%); while, negative consensus (s20.4; s21.5) and no consensus (s11.5, s17) were reached for 2 statements, respectively (9%). Conclusion: The Delphi results underline the importance of first-line interdisciplinary management, with large pre-treatment examination, and establish a common opinion on how to properly manage post-operative IWL/WR. Level of evidence V: Report of expert committees.
Original languageEnglish
Pages (from-to)1-5
Number of pages5
JournalEating and Weight Disorders
Publication statusPublished - 2023


  • Insufficient weight loss approach
  • Italian Delphi consensus
  • Obesity pre-operative management
  • Obesity treatment
  • Weight regain approach


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