1. Religious Fasting of Muslim Patients After Metabolic and Bariatric Surgery: a Modified Delphi Consensus
- Author
-
Khaled Gawdat, Ahmet Ziya Balta, Karim Sabry, Ali Aminian, Mousa Khoursheed, Maazulhassan, Faki Akin, Taryel Omarov, Mustafa Taskin, Khaleel Mohammad, Bijan Ghavami, Osama Taha, Waleed Bukhari, Yasser Kayyal, Radwan Kassir, Mehdi Skalli, Ahmad Bashir, Amir Hossein Davarpanah Jazi, Mumtaz Maher, Tahir Yunus, Ashraf Haddad, Mohammad Kermansaravi, Ramen Goel, Selim Jalil Illan, K S Kular, Ebrahim Aghajani, Aayed R. Alqahtani, Mohammad Talebpour, Tarek Mahdy, Tikfu Gee, Tarek A.O Abouzeid, Mohamed G Qassem, Haris Khwaja, Atif Inam, Bader AlHadhrami, Muhammad S Niam, Kamal Mahawar, Mujjahid Abbas, Halit Eren Taskin, Syed Tanseer Asghar, Masoud Rezvani, Abdolreza Pazouki, Mohanad AlAnsari, Abdelrahman Nimeri, Shahab Shahabi, Waleed Gado, Alaa Abbass, Amir Ulhagh Khan, Ebrahim Mansoor, Asim Shabbir, Safauldeen Salim, Mohammad AlHaifi, Laurent Abram Layani, Ibrahim Hassan, Ali AlHamdani, Syed Imran Abbas, Mohammed AlHadad, Salman Mirza, Aiman Ismaeil, Islam Omar, and Mohamad Hayssam ElFawal
- Subjects
medicine.medical_specialty ,Consensus ,animal structures ,Delphi Technique ,Endocrinology, Diabetes and Metabolism ,Modified delphi ,Bariatric Surgery ,Disease ,Islam ,Weight loss ,Humans ,Medicine ,In patient ,Nutrition and Dietetics ,business.industry ,Metabolic surgery ,Type 2 Diabetes Mellitus ,Fasting ,medicine.disease ,Obesity ,Obesity, Morbid ,Surgery ,Diabetes Mellitus, Type 2 ,medicine.symptom ,business ,Dyslipidemia - Abstract
Background Fasting during Ramadan is one of the five pillars of the Muslim faith. Despite the positive effects of fasting on health, there are no guidelines or clear recommendations regarding fasting after metabolic/bariatric surgery (MBS). The current study reports the result of a modified Delphi consensus among expert metabolic/bariatric surgeons with experience in managing patients who fast after MBS. Methods A committee of 61 well-known metabolic and bariatric surgeons from 24 countries was created to participate in the Delphi consensus. The committee voted on 45 statements regarding recommendations and controversies around fasting after MBS. An agreement/disagreement ≥ of 70.0% was regarded as consensus. Results The experts reached a consensus on 40 out of 45 statements after two rounds of voting. One hundred percent of the experts believed that fasting needs special nutritional support in patients who underwent MBS. The decision regarding fasting must be coordinated among the surgeon, the nutritionist and the patient. At any time after MBS, 96.7% advised stopping fasting in the presence of persistent symptoms of intolerance. Seventy percent of the experts recommended delaying fasting after MBS for 6 to 12 months after combined and malabsorptive procedures according to the patient's situation and surgeon's experience, and 90.1% felt that proton pump inhibitors should be continued in patients who start fasting less than 6 months after MBS. There was consensus that fasting may help in weight loss, improvement/remission of non-alcoholic fatty liver disease, dyslipidemia, hypertension and type 2 diabetes mellitus among 88.5%, 90.2%, 88.5%, 85.2% and 85.2% of experts, respectively. Conclusion Experts voted and reached a consensus on 40 statements covering various aspects of fasting after MBS.
- Published
- 2021