Obesity is a well-established risk factor for a wide range of health conditions, including diabetes, cardiovascular disease, and certain cancers. The clinical importance of severe obesity (body mass index [BMI] ≥40 kg/m2) has been brought to the forefront recently as this patient subgroup has received prioritisation for coronavirus vaccination. A recent meta-analysis reported that patients with obesity had an increased risk of hospitalisation (113% higher), ICU admission (74% higher), and death (48% higher) from coronavirus infection.1 In March 2021, the Department of Health and Social Care announced over £70 million funding to be invested in weight management services, stating that this will also be used to ‘support GPs and other health professionals to help make weight management an integral part of routine care’ .2 The National Institute for Health and Care Excellence (NICE) recommends bariatric surgery as a treatment option for patients with a BMI ≥40 kg/m2 or ≥35 kg/m2 with obesity-related comorbidities, who have not managed adequate weight loss through nonsurgical measures.3 Bariatric surgery is the most clinically effective treatment for severe and complex obesity in terms of weight loss and improvement of comorbidities such as type 2 diabetes and hypertension. After bariatric surgery, guidelines recommend patients are followed up in specialist bariatric services for at least 2 years and then discharged under a shared-care model with annual monitoring of nutritional status and appropriate supplementation, to prevent complications from nutritional deficiencies.3–5 Parretti and colleagues’ retrospective cohort study explores whether primary care follow-up after discharge from specialist bariatric services is in accordance with the NICE and British Obesity and Metabolic Surgery Society (BOMSS) guidance.3,4,6 Overall, they conclude that patients are not receiving appropriate nutritional monitoring post-specialist discharge, with variability in annual recommended nutritional …
