Recommendations

Document Overview

Design and created by Guideline Central in participation with the American Association of Clinical Endocrinologists, American Society for Metabolic and Bariatric Surgery, American Society of Anesthesiologists, Obesity Medicine Association, and The Obesity Society.

Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient

American Association of Clinical Endocrinologists

American Society for Metabolic and Bariatric Surgery

American Society of Anesthesiologists

The Obesity Society

Obesity Medicine Association

Publication Date: Nov 1, 2019

Page Last Updated: May 5, 2026

AACEGrading System

Document Overview

Document Title: Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient

Authoring Societies

American Association of Clinical Endocrinologists

American Society for Metabolic and Bariatric Surgery

American Society of Anesthesiologists

The Obesity Society

Obesity Medicine Association

Endorsing Society: American Society for Parenteral and Enteral Nutrition

Document Publication Date: Nov 1, 2019

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: www.endocrinepractice.org/article/S1530-891X(20)42802-2/fulltext

Source Citation: Mechanick JI, Apovian C, Brethauer S, Garvey WT, Joffe AM, Kim J, Kushner RF, Lindquist R, Pessah-Pollack R, Seger J, Urman RD, Adams S, Cleek JB, Correa R, Figaro MK, Flanders K, Grams J, Hurley DL, Kothari S, Seger MV, Still CD. CLINICAL PRACTICE GUIDELINES FOR THE PERIOPERATIVE NUTRITION, METABOLIC, AND NONSURGICAL SUPPORT OF PATIENTS UNDERGOING BARIATRIC PROCEDURES - 2019 UPDATE: COSPONSORED BY AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS/AMERICAN COLLEGE OF ENDOCRINOLOGY, THE OBESITY SOCIETY, AMERICAN SOCIETY FOR METABOLIC & BARIATRIC SURGERY, OBESITY MEDICINE ASSOCIATION, AND AMERICAN SOCIETY OF ANESTHESIOLOGISTS - EXECUTIVE SUMMARY. Endocr Pract. 2019 Dec;25(12):1346-1359. doi: 10.4158/GL-2019-0406. Epub 2019 Nov 4. PMID: 31682518.

Supplemental Implementation Resources

Podcast

Document Scope, Criteria, and Use Cases

Scope: Assessment and Screening, Counseling, Management, Prevention

Diseases/Conditions (MeSH)

D052938 - Bariatric Medicine

D050110 - Bariatric Surgery

D052938 - Bariatric Medicine

Keywords: bariatric surgery, nutrition

Inclusion Criteria: Female, Male, Adult, Older Adult

Health Care Settings: Ambulatory, Hospital, Operating and Recovery Room, Outpatient

Intended Users: Dietician/Nutritionist, Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Number of Source Documents: 859

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: No

Recommendation Grading
Grade	Definition	Descriptors
A	Strong	“must”
B	Intermediate	“should”
C	Weak	“may”
D	No conclusive evidence and/ or expert opinion	any

Strength of Evidence	Definition
H	High
I-H	Intermediate-High
I	Intermediate
L-I	Low-Intermediate
L	Low
L-E	Low/Expert Opinion