Objective:

To propose evidence-informed definitions for weight recurrence (WR), partial response, and nonresponse following metabolic and bariatric surgery (MBS), emphasizing the need to address the chronic nature of obesity post-surgery and to offer practical clinical recommendations for their management.

Key Findings:

• Weight recurrence (WR) rates vary widely, ranging from 9% to 91%, highlighting the need for standardized definitions and the implications of this variability on patient care.
• Definitions of WR, partial response, and nonresponse are often conflated, despite representing distinct conditions with unique management needs.
• Only 54% of studies discussed clinical management strategies for WR, with significant variability based on provider specialty, indicating a need for unified clinical guidelines.

Interpretation:

The review underscores the urgent need for unified definitions and standardized clinical frameworks to improve the management of WR and related conditions following MBS, and highlights the necessity for clinical guidelines to support this effort.

Limitations:

• Significant knowledge gaps exist in the literature regarding the management of WR, which may hinder effective clinical practice.
• Many studies lack high-quality evidence, standardized definitions, and long follow-up durations, limiting their applicability.

Conclusion:

Establishing clear definitions and coordinated management strategies is essential for optimizing care and addressing the chronic nature of obesity post-surgery, emphasizing the urgency of these efforts in clinical settings.