Evidence Based Medicine on FHIR Implementation Guide, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/ebm/ and changes regularly. See the Directory of published versions

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: Recommendation: ADA Obesity Management Recommendation 8.16 - XML Representation

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    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Composition 179466</b></p><a name="179466"> </a><a name="hc179466"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">version: 37; Last updated: 2025-07-22 19:21:04+0000</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-recommendation.html">Recommendation</a></p></div><p><b>Artifact Description</b>: </p><div><p>Example of Recommendation Profile of Composition Resource.</p>
</div><p><b>url</b>: <a href="https://fevir.net/resources/Composition/179466">https://fevir.net/resources/Composition/179466</a></p><p><b>identifier</b>: FEvIR Object Identifier/https://fevir.net/FOI/179466</p><p><b>status</b>: Final</p><p><b>type</b>: <span title="Codes:{https://fevir.net/resources/CodeSystem/179423 Recommendation}">Recommendation</span></p><p><b>date</b>: 2025-07-22 19:21:04+0000</p><p><b>author</b>: Brian S. Alper</p><p><b>title</b>: Recommendation: ADA Obesity Management Recommendation 8.16</p><p><b>custodian</b>: <a href="Organization-118079.html">Computable Publishing LLC</a></p><h3>RelatesTos</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Target[x]</b></td></tr><tr><td style="display: none">*</td><td>Cite As</td><td><div><p>Recommendation: ADA Obesity Management Recommendation 8.16 [Database Entry: FHIR Composition Resource]. Contributors: Brian S. Alper [Authors/Creators]. In: Fast Evidence Interoperability Resources (FEvIR) Platform, FOI 179466. Revised 2025-07-22. Available at: https://fevir.net/resources/Composition/179466. Computable resource at: https://fevir.net/FLI/DocumentForComposition179466.</p>
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  <title value="Recommendation: ADA Obesity Management Recommendation 8.16"/>
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      <div xmlns="http://www.w3.org/1999/xhtml">&lt;8.16 Metabolic surgery should be a recommended option to treat type 2 diabetes in screened surgical candidates with BMI ≥40 kg/m2 (BMI ≥37.5 kg/m2 in Asian Americans) and in adults with BMI 35.0–39.9 kg/m2 (32.5–37.4 kg/m2 in Asian Americans) who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods. A</div>
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      <div xmlns="http://www.w3.org/1999/xhtml">Inclusion Criteria: [[1]] Adults. [[2]] Diagnosed with type 2 diabetes. [[3]] Body Mass Index (BMI) ≥ 40.0 kg/m2 (BMI ≥ 37.5 kg/m2 in Asian Americans), or BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 (BMI 32.5-37.4 kg/m2 in Asian Americans) who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods. [[4]] Screened surgical candidates.</div>
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      <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Title: </b>Justification for Recommendation: ADA Obesity Management Recommendation 8.16</p><br/><p><b>Justification for Recommendation: </b>Recommendation: ADA Obesity Management Recommendation 8.16</p><br/><table><tr><th>Concept</th><th>Summary</th><th>Rating</th></tr><tr><td>Evidence (coded as: evidence from https://fevir.net/resources/CodeSystem/179423)</td><td>ADA Level of Evidence A. A substantial body of evidence has now been accumulated, including data from numerous randomized controlled (nonblinded) clinical trials, demonstrating that metabolic surgery achieves superior glycemic control and reduction of cardiovascular risk factors in patients with type 2 diabetes and obesity compared with various lifestyle/medical interventions.</td><td>undefined</td></tr><tr><td>Summary of Findings (coded as: summary-of-findings from https://fevir.net/resources/CodeSystem/179423)</td><td>ADA Level of Evidence A. A substantial body of evidence has now been accumulated, including data from numerous randomized controlled (nonblinded) clinical trials, demonstrating that metabolic surgery achieves superior glycemic control and reduction of cardiovascular risk factors in patients with type 2 diabetes and obesity compared with various lifestyle/medical interventions.</td><td>undefined</td></tr><tr><td>Discussion (coded as: discussion from https://fevir.net/resources/CodeSystem/179423)</td><td>A substantial body of evidence has now been accumulated, including data from numerous randomized controlled (nonblinded) clinical trials, demonstrating that metabolic surgery achieves superior glycemic control and reduction of cardiovascular risk factors in patients with type 2 diabetes and obesity compared with various lifestyle/medical interventions.<br/>In extended follow-up of obese adults with type 2 diabetes randomized to adding gastric bypass compared with lifestyle and intensive medical management alone, there remained a significantly better composite triple end point in the surgical group at 5 years. However, because the effect size diminished over 5 years, further follow-up is needed to understand the durability of the improvement.</td><td>undefined</td></tr><tr><td>Competing Interests (coded as: competing-interests from https://fevir.net/resources/CodeSystem/179423)</td><td>All members of the PPC are required to disclose potential conflicts of interest with industry and other relevant organizations. These disclosures are discussed at the outset of each Standards of Care revision meeting. Members of the committee, their employers, and their disclosed conflicts of interest are listed in 'Disclosures: Standards of Medical Care in Diabetes—2021' (https://doi.org/10.2337/dc21-SPPC). The ADA funds development of the Standards of Care out of its general revenues and does not use industry support for this purpose. NOTE: The disclosed conflicts of interest was not found at the suggested URL</td><td>undefined</td></tr></table><br/></div>
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      <div xmlns="http://www.w3.org/1999/xhtml">ADA Level of Evidence A. A substantial body of evidence has now been accumulated, including data from numerous randomized controlled (nonblinded) clinical trials, demonstrating that metabolic surgery achieves superior glycemic control and reduction of cardiovascular risk factors in patients with type 2 diabetes and obesity compared with various lifestyle/medical interventions.</div>
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