Table 4.

Recommendations for Preoperative Optimization: Obesity.

Obesity

○ Assess medical and psychosocial factors followed by shared decision-making between surgeon and patient to create weight loss goals of 5–10% of body weight

○ Coordinate with surgeons, nutritionists, and dietitians for referral to metabolic weight loss programs or bariatric treatment

○ Coordinate with surgeons for early distribution of weight management information and resources for lifestyle modification through diets, exercise plans, referral to dietitians or nutritionists

○ Coordinate with PCP and surgeon to assess and follow patient progress, discuss consideration of pharmacotherapy such as GLP-1 agonists (liraglutide or semaglutide), phentermine-topiramate, bupropion-naltrexone, orlistat, metformin, or SGLT-2 inhibitors, assist with managing comorbidities and directing patient to bariatric surgery or behavioral counseling

○ Advocate for patient requirement to attend accessible joint class incorporating education on effects of weight in advance of surgery, supplementation with online patient platforms

PCP: primary care provider, SGLT-2: sodium-glucose cotransporter-2, GLP-1: glucagon-like peptide-1