Canadian Adult Obesity Clinical Practice Guidelines - Bariatric Surgery: Selection & Pre-Operative Workup

Sep 27, 2026

Uploaded by Patrick

Guidance for selecting adult candidates for bariatric surgery and completing pre-operative assessment to reduce surgical risk and improve long-term outcomes. The document highlights criteria for eligibility, emphasizes multidisciplinary evaluation of medical, nutritional, mental, and functional health, and outlines further testing such as cardiac, respiratory, metabolic, gastrointestinal, and sleep apnea investigations. It stresses peri-operative optimization for patients with type 2 diabetes, the need for mandatory tobacco cessation, and structured preparation including nutrition and behavioural interventions.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Key Messages for Healthcare Providers

Recommendations

Key Messages for People Living with Obesity

Selection of Appropriate Patients for Bariatric Surgery

Bariatric Surgery: Selection & Pre-Operative Workup Stephen Glazer MDi, Laurent Biertho MDii i) Department of Internal Medicine, University of Toronto ii) Department of Surgery, Laval University Cite this Chapter Glazer S, Biertho L. Canadian Adult Obesity Clinical Practice Guidelines: Bariatric Surgery: Selection & Pre-Operative Workup. Available from: [https://obesitycanada.ca/guidelines/preop](https://obesitycanada.ca/guidelines/preop. Accessed)[. Accessed](https://obesitycanada.ca/guidelines/preop. Accessed)[ ](https://obesitycanada.ca/guidelines/preop. Accessed)[date] . Update History Version 1, August 4, 2020. The Canadian Adult Obesity Clinical Practice Guidelines are a living document, with only the latest chapters posted at obesitycanada.ca/guidelines. KEY MESSAGES FOR HEALTHCARE PROVIDERS • Criteria for selection of appropriate candidates for bariatric surgery have been established to minimize surgical complications and to maximize the benefit of these important and limited procedures. • The pre-operative workup should evaluate a patient’s medical, nutritional, mental and functional health status. • Special attention should be given to the care of patients living with type 2 diabetes (T2DM) who are considering bariatric surgery to minimize complications from uncontrolled diabetes in the peri-operative period. • Because of the risks of post-operative complications associated with tobacco use, cessation prior to bariatric surgery is mandatory and should be maintained lifelong. • In patients living with severe obesity, bariatric surgery, in combination with behavioural interventions, is a more effective option for long-term weight loss and control of chronic conditions, such as T2DM, hypertension, sleep apnea and dyslipidemia, as well as other conditions associated with increased adiposity. RECOMMENDATIONS • We suggest a comprehensive medical and nutritional • We suggest screening for and treatment of obstructive evaluation be completed and nutrient deficiencies corrected sleep apnea in people seeking bariatric surgery (Level 4, in candidates for bariatric surgery (Level 4, Grade D) .1,2 Grade D) .4,5 • Pre-operative smoking cessation can minimize post-operative complications (Level 2a, Grade B) .3 KEY MESSAGES FOR PEOPLE LIVING WITH OBESITY • Bariatric surgery is the beginning of a life-long journey. You should educate yourself about the necessary changes required to optimize your long-term outcomes for a healthier life. • Before surgery you will be asked to perform several investigations, such as blood work and cardiac or pulmonary testing, to ensure that you are ready and safe for surgery. • If you are at high risk for obstructive sleep apnea, you maybe asked to undergo a sleep study to determine if you have significant sleep apnea. • A current or recent history of smoking or nicotine consumption puts you at risk of complications after bariatric surgery. Smoking cessation is required before surgery, and must be maintained for life. • You may be given a low-calorie diet two to three weeks before surgery in order to shrink your liver size and make your surgery easier. • If you are living with diabetes, you will have to follow your blood sugars very closely and obtain instructions on how to adjust your diabetes medications while on the low-calorie diet prior to bariatric surgery. • Because changes in the absorption of some medications may occur with certain bariatric surgical procedures, you may be asked to change either the type or preparation of the medication you are currently taking. Selection of appropriate patients for bariatric surgery Extensive preparation of patients prior to bariatric surgery is required. Potential candidates for bariatric surgery undergo multidisciplinary evaluation and optimization of their medical, mental, nutritional and functional health to assess their eligibility and safety to proceed with surgery. Further medical evaluations may

FAQs

What does the pre-operative workup for bariatric surgery evaluate?

It evaluates a patient’s medical, nutritional, mental, and functional health status, including further testing as needed (e.g., cardiac, respiratory, metabolic, gastrointestinal, and sleep apnea testing).

Which patients with type 2 diabetes require special attention?

Patients living with type 2 diabetes (T2DM) who are considering bariatric surgery need special attention to minimize complications related to uncontrolled diabetes in the peri-operative period.

Why is smoking cessation mandatory before bariatric surgery?

Tobacco use increases the risk of post-operative complications, so cessation prior to bariatric surgery is mandatory and should be maintained lifelong.

Sep 27, 2026

Uploaded by Patrick