American Society for Metabolic and Bariatric Surgery

American Society for Metabolic and Bariatric Surgery statement on the treatment options for patients with non-response and weight recurrence after metabolic and bariatric surgery

2026United States

Contenu en anglais

Lire la recommandation officielleInterroger Osler sur cette recommandation

Synthèse

This clinical statement by the American Society for Metabolic and Bariatric Surgery (ASMBS) provides an overview of treatment strategies for patients experiencing inadequate weight loss (non-response) or weight regain (weight recurrence) following bariatric surgery. It covers revisional bariatric surgical options, endoscopic interventions, and newer obesity modifying medications, highlighting the necessity of individualized, multidisciplinary management.

Metabolic and bariatric surgery is highly effective, but a subset of patients experience non-response or weight recurrence, which requires further treatment to manage persistent metabolic diseases and improve quality of life.

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Messages clés

Metabolic and bariatric surgery (MBS) is highly effective for severe obesity, but some patients experience inadequate weight loss (non-response) or weight regain (weight recurrence).
Managing non-response and weight recurrence requires an individualized, multidisciplinary approach on a case-by-case basis.
Treatment strategies include surgical revisions (e.g., pouch revision, distalization, conversion), endoscopic therapies (e.g., transoral outlet reduction), and obesity modifying medications (OMMs).
Obesity modifying medications, particularly GLP-1 receptor agonists like semaglutide and dual peptide receptor agonists like tirzepatide, are major recent advances.
Overall data quality is limited by high loss to follow-up and outcome variability across all treatment modalities.

Champ d’application et patients concernés

Thème clinique

Treatment options for patients with non-response and weight recurrence after metabolic and bariatric surgery

Objectifs

Summarize current treatment options for non-response and weight recurrence after metabolic and bariatric surgery

Population de patients

Patients with non-response and weight recurrence after metabolic and bariatric surgery

Critères diagnostiques

Inadequate weight loss is defined as non-response (NR), and weight regain is defined as weight recurrence (WR) after bariatric surgery.

Professionnels concernés

Bariatric surgeons
Endoscopists
Obesity medicine specialists

Définitions

NR: Non-response (inadequate weight loss after metabolic and bariatric surgery)
WR: Weight recurrence (weight regain after metabolic and bariatric surgery)
MBS: Metabolic and bariatric surgery
OMMs: Obesity modifying medications

Pour apprendre

Dans cette recommandation

Groupe de travail pluridisciplinaire

Niveau

Advanced

Parcours d’apprentissage

Bariatric Surgery
Obesity Medicine
Revisional Surgery
Endoscopic Therapy
Pharmacotherapy

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En bref

Organisme: American Society for Metabolic and Bariatric Surgery
Date de publication: 2026
Région: United States
Langue: English
DOI: 10.1016/j.soard.2026.04.002
Ajout sur Prognia: 23 juillet 2026

Mots-clés

non-response
weight recurrence
metabolic and bariatric surgery
revisional surgery
endoscopic therapies
obesity modifying medications