Obesity pillars roundtable: Better together - combined obesity medicine and metabolic surgery care for the treatment of obesity
Bibliographic record
Abstract
Background: Obesity is a chronic, multifactorial, complex, and relapsing disease typically requiring treatment from various medical providers throughout the continuum of care. A natural overlap in medical and procedural obesity treatment therefore often exists during the course of treatment. Given this, the optimal treatment of the medically complex patient population may best be delivered either within multi-disciplinary teams, or through more effective collaboration with diverse specialists sharing the common interest of managing patients with obesity. The aim of this roundtable is to more deeply engage on issues surrounding the multi-disciplinary approach for the treatment of obesity, along with highlighting areas of opportunity for improving collaborative care. Methods: This roundtable review includes perspectives from two obesity medicine specialists and two metabolic bariatric surgeons, all with extensive experience in combining medical and surgical care. Results: While the panelists generally agreed upon core principles of combined obesity medicine and metabolic surgical care for the treatment of obesity, each had their own priorities and approach regarding the best ways to overlap care. Variances in perceptions included importance of procedural care versus use of pharmacotherapy. However, the panelists endorsed more collaborative work as vital for improving outcomes. Further identification of existing barriers and the creation of pathways for action will bring this work forward. Conclusions: Providing guidance on one universal approach to the care of patients with obesity is challenging due to the heterogeneity of patient populations and variance in practice patterns across the spectrum of care. The panel suggested adopting a continuum-of-care mindset, meaning that all available options should be considered for patients, either in sequence, or as adjuvant therapies, or as rescue options for patients who gain tolerance to a particular therapeutic modality. This approach is in keeping with the reality that obesity is a chronic, relapsing multifactorial disease.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.022 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.007 | 0.011 |
| Open science | 0.003 | 0.009 |
| Research integrity | 0.012 | 0.016 |
| Insufficient payload (model declined to judge) | 0.021 | 0.007 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".