Aim: We aimed to systematically review the psychological and social outcomes of patients after bariatric surgery. Material and methods: The comprehensive search using keywords yielded 1224 records utilizing search engines: PubMed and Scopus. After a careful analysis, 90 articles were found to be eligible for complete screening that collectively reported the use of 11 different BS procedures among 22 countries. Results: This review is unique in that we collectively presented the result of various psychological and social outcome parameters (depression and anxiety, self-confidence, self-esteem, marital relationship, and personality traits) after BS. Regardless of the BS procedures performed, most studies over months to years presented a positive outcome of the parameters considered, while few presented contrasting unsatisfactory results. Thus, the surgery was not a cessation factor for these results to be permanent and thus suggested psychological interventions and long-term monitoring for assessing the psychological effects after BS. Additionally, the patient's endurance to check weight and eating habits after surgery is ultimately necessary.

Background: Competence-Based Medical Education CBME becomes an essential requirement amongst medical education and practice societies. In response to the increasing call for national standard of Saudi medical education, the Denary of Saudi Medical Colleges developed “Saudi MEDs project ” in 2009, which aimed to have a national competence-based framework for medical schools. Purpose: This paper summarizes Phase II of the Saudi MEDs project, which aims to develop a comprehensive competence-based medical education framework for medical schools. This includes detailed statement of the essential learning outcomes and enabling competences for each domain identified in Phase I of the project. Method: Triangulation approach is utilized to increase the credibility and validity of research findings. The study consists of two-round Modified Delphi Technique; Focused Group interviews with stakeholders; and structural review by international experts. Results: The Saudi MEDs framework is expressed as a three-level model; six major themes related to a description of a physician's duties and obligations (Level1), seventeen essential learning outcomes of a physician (Level 2), eighty enabling competences to be fulfilled by all undergraduate medical programs in Saudi Arabia (Level 3). Discussion: The Saudi MEDs framework is expressed as a three-level model, which provides flexibility to ensures a school autonomy and diversity of contextual curricula. Also the study develop national consensus among stakeholders about the framework and its importance to develop and maintain a quality medical education and practice in the Kingdom. However, successful deployment of the Saudi MEDs required a strategic plan and roadmap.

Laparoscopic sleeve gastrectomy (LSG) remains an effective standalone bariatric surgery. Some patients might experience gastroesophageal reflux (GERD) symptoms post LSG despite its beneficial outcome on weight loss and improving obesity morbidities. This study aims to determine the prevalence of post-LSG GERD symptoms and associated risk factors.

Background: Severe obesity is a growing global health challenge, and metabolic bariatric surgery (MBS) is an effective treatment. However, the clinical relevance of routine preoperative thyroid assessments remains unclear. This cross-sectional study investigated the relationship between baseline thyroid-stimulating hormone (TSH) levels and other biochemical parameters during preoperative MBS. Patients and Methods: Over 12 months (June 2024 to June 2025), 208 patients aged > 15 years undergoing preoperative evaluation for MBS at our referral center were considered for the study. Patients with prior bariatric/major abdominal surgery, active thyroid disease or thyroid-active medications (with a 3-month washout), or acute severe illness were excluded from the study. Fasting blood serum TSH was measured within one week before hospital admission, categorized using standard cutoffs, and statistical analysis was performed. Results: The mean age and preoperative body mass index (BMI) were 36.6 ± 11.2 years and 43.7 ± 6.4 kg/m2 (range 33.05-84.0), respectively. The serum TSH levels ranged from 0.02 to 14.13 (mean: 1.70 ± 1.46 mIU/L). The serum creatinine and albumin levels demonstrated a mean value of 61.3 ± 14.3 µmol/L (range: 37.8-155 µmol/L) and 43.2 ± 2.6 g/L (range: 36-50 g/L), respectively. Correlation analyses showed no statistically significant associations between TSH and age, BMI, HbA1c, hemoglobin, creatinine, or albumin levels (Pearson and Spearman coefficients). The prevalence of TSH abnormalities was not significantly different according to age group (χ2 = 6.106, p = 0.978) or gender (χ2 = 1.445, p = 0.695). Multivariable linear regression for log-transformed TSH showed that age, BMI, HbA1c, and creatinine were not significant predictors. Most patients were euthyroid (92.8%), with 3.8% low TSH. Further, TSH levels showed no significant correlations with BMI (r = 0.032), hemoglobin, HbA1c, creatinine, or albumin, and did not differ by age group or gender. Conclusions: These findings suggest that, in patients with severe obesity undergoing preoperative evaluation for MBS, TSH levels are generally within the reference range and are not statistically influenced by the measured biochemical or demographic factors. This supports a more clinically driven approach to thyroid testing while emphasizing the need for larger, multicenter, and longitudinal studies to clarify thyroid-obesity relationship and postoperative outcomes.

Purpose: In light of the increasing prevalence of esophagogastric cancer (EGC), the altered anatomy after bariatric surgery (BS) (mainly laparoscopic sleeve gastrectomy [LSG] and roux-en-Y gastric bypass [RYGB]) presents difficulties in treating these cancers. The article focuses on the risk factors associated with the development of EGC post-LSG and RYGB. Methods: Relevant articles were identified from databases such as SCOPUS, PubMed, and Web of Science (from 2010 to May 2022). From the selected and screened articles, a meta-analysis was performed using different statistical methods by calculating odds ratios, the t-test, and the discrepancies (95% confidence interval), to estimate the incidence of GC. Publication bias was estimated based on Cochrane risk tool and Newcastle–Ottawa Quality Assessment Scale. Results: The study included case reports (26), random control trials (RCT) (2), case series (6), and prospective (2) and retrospective studies (5). The current article also includes one each of epidemiological and medical administrative database studies. The 43 selected articles comprised 807,458 patients with BS, where 57.5% underwent LSG and 42.5% underwent RYGB. The average age and body mass index (BMI) were 48.11 and 43.53 ± 8.97 in the case of LSG, respectively. The average age was 52.77 and BMI was 42.62 ± 9.21 for RYGB. The obtained results suggested that cancer development is at higher risk in LSG among patients with comorbidities, absence of Helicobacter pylori, and delayed diagnosis, irrespective of their smoking habit. The incidence of the tumor or cancer and its severity is higher after LSG with 41.17% in comparison to RYGB 9.52%. A significant variation was observed in the period of cancer diagnosis. A minimum of 2 and 4 months and a maximum of 96 and 252 months variation have been observed for LSG and RYGB, respectively. No publication bias was noticed based on the selected articles. Furthermore, no direct correlation was identified or measured between the development of ECG and LSG/REYGB surgeries from the collected literature. EGC therapy following BS is complex and requires a personalized strategy that carefully balances optimal treatment with anatomical limitations. Conclusions: The risk factors like obesity, comorbidities, smoking, H. pylori infection, tumor stage, and diagnostic tests must be evaluated before BS. Although the current evidence-based practice does not advocate for a routine preoperative endoscopy, we highly advise for a preoperative endoscopic procedures before BS in the presence of the highlighted EGC risk factors.