Postoperative Management After Metabolic Surgery: Role of the Family Physician

Obesity is associated with cardiometabolic risk factors and increased mortality. Treatment of obesity includes lifestyle modifications, pharmacotherapy, and surgical management with metabolic and bariatric surgery. In 2022, approximately 270,000 bariatric procedures were performed in the United States. Metabolic and bariatric surgery produces sustained weight loss and improvement in chronic conditions such as type 2 diabetes, hypertension, obstructive sleep apnea, and infertility. Family physicians are positioned to provide long-term care for patients seeking surgical attention for obesity and obesity-related complications, highlighting the importance of education regarding associated acute, subacute, and chronic complications, and changes in neurohormonal regulation that affect digestion and fertility. Improvements in obesity-related conditions should be monitored and medications adjusted as necessary. Understanding of common complications (eg, gastroesophageal reflux disease, dumping syndrome, changes in stool habits, nutritional deficiencies) and changes in cardiometabolic risk factors and fertility enables the family physician to provide comprehensive care for patients after metabolic and bariatric surgery.