Expert-consensus recommendations and SEPD certification criteria for bariatric and metabolic endoscopy units. Position paper of the Sociedad Española de Patologia Digestiva (SEPD)

The Sociedad Española de Patología Digestiva (SEPD) has developed a position statement setting out expert-consensus recommendations considered essential for the structure, organization, and functioning of Bariatric and Metabolic Endoscopy Units (BMEU) operating within Departments of Gastroenterology, with the aim of enabling these units to carry out their activities efficiently and with high quality. The document defines the BMEU -including a proposed minimum activity volume as a certification criterion- and establishes provisional certification criteria relating to their organization, structure, service portfolio, processes, articulation with the pharmacological treatment of obesity, framework criteria for patient selection, safety, and aspects concerning training and research. The provisional certification criteria have been classified as mandatory (recommendations whose fulfilment is required to qualify for SEPD certification) and recommendations. These provisional certification criteria should be reviewed within no more than five years, on the basis of the experience gained in Spanish BMEUs and the evolution of scientific knowledge in bariatric and metabolic endoscopy and in the comprehensive management of obesity. The development of performance indicators-including patient-reported outcome measures (PROMs)-is identified as a relevant challenge, as is the generation of evidence on the association between consensus-based recommendations on BMEU structure and activity and health outcomes. The methodological limitations of the present document and the need to incorporate the patient perspective in future updates are explicitly acknowledged.