减重代谢手术后减重平台期管理专家共识(2025版)

Expert consensus on weight loss plateau phase management after bariatric metabolic surgery (2025 edition)

  • 摘要:
    《减重代谢手术后减重平台期管理专家共识(2025版)》(以下简称共识)旨在为临床医师提供科学、规范的减重平台期管理策略,优化术后随访及干预措施,以改善患者远期预后和提高生命质量。
    共识由四川大学华西医院、暨南大学附属第一医院、中南大学湘雅三医院联合发起,组织减重代谢外科、临床营养学、内分泌代谢科、心理学及运动医学等多学科专家共同制订。共识工作组系统检索建库至2024年的国内外相关文献,并结合临床实践形成初稿。共识研讨采用改良德尔菲法,经3轮专家论证:第1轮邀请全国33位具有丰富减重代谢外科个案管理、医疗和护理管理经验的专家组成编审委员会进行开放式函询;第2轮由33位专家对共识修订稿进行结构化评分;第3轮组织6位具有>8年减重代谢外科个案管理经验的专家进行访谈,并以函审形式完成,对存在争议的问题深度讨论并补充循证医学证据后达成一致。
    共识涵盖4大核心内容:(1)病因学分析及病理生理机制解读。(2)减重平台期的标准化评估体系。(3)多学科协作的阶梯化管理策略。(4)长期随访方案及支持体系构建。
    共识为临床实践提供循证、规范的管理框架,建议在实施过程中结合患者个体化特征及时调整。

     

    Abstract:
    Objective The Expert Consensus on Weight Loss Plateau Phase Management after Bariatric Metabolic Surgery (2025 Edition) (hereinafter referred to as the Consensus) aims to provide clinicians with scientific and standardized strategies for managing weight loss plateau phase, optimizing postoperative follow‑up and interventions to improve long‑term outcomes and quality of life.
    Methods The Consensus was jointly initiated by West China Hospital of Sichuan University, The First Affiliated Hospital of Jinan University, and The Third Xiangya Hospital of Central South University, formulated by experts from multiple disciplines including bariatric and metabolic surgery, clinical nutrition, endocrinology, psychology, and sports medicine. The working group systematically reviewed relevant literature up to 2024 and drafted the initial version based on clinical practice. The Consensus development adopted a modified Delphi method, comprising three rounds of expert review. In the first round, an open‑ended questionnaire was distributed to a 33‑member editorial board of experts with extensive experience in case management, medical, and nursing care in bariatric and metabolic surgery. In the second round, the same 33 experts conducted structured scoring of the revised draft. In the third round, six experts with over 8 years of experience in case management of bariatric and metabolic surgery participated in in‑depth interviews and written reviews to resolve controversial issues, supplemented by additional evidence‑based medical data to reach a final agreement.
    Results The Consensus covers four core components, including etiological analysis and pathophysiological mechanisms, standardized assessment system for weight loss plateaus phase, multidisciplinary, stepwise management strategies, and long‑term follow‑up protocols and support systems.
    Conclusion The Consensus provides an evidence‑based and standardized management framework for clinical practice, recommending individualized adjustments based on patient‑specific factors.

     

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