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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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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\u00a0years) weight regain (WR) or insufficient weight loss (IWL); (4) Management of the patient with medium-term (5\u00a0years) 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence V<\/jats:title><jats:p>Report of expert committees.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s40519-023-01537-4","type":"journal-article","created":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T17:27:50Z","timestamp":1676050070000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["SICOB-endorsed national Delphi consensus on obesity treatment optimization: focus on diagnosis, pre-operative 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