Polish Expert Consensus on Metabolic and Bariatric Surgery: 2025 update.

This document presents a comprehensive update to the Polish national recommendations on metabolic and bariatric surgery, developed by a panel of experts based on the latest clinical and scientific evidence. In light of a nearly 500% increase in the number of bariatric procedures in Poland since 2014 and significant technological advancements, it became necessary to revise national guidelines in line with international standards set by the International Federation for the Surgery of Obesity and Metabolic Disorders and the American Society for Metabolic and Bariatric Surgery. A pivotal development in Poland was the implementation of the Comprehensive Specialist Care in Bariatrics (KOS‑BAR) program in 2021, which ensured more accessible and safer care for patients with severe obesity through a structured and multidisciplinary approach. The consensus covers the full scope of care: from the epidemiology of obesity, surgical eligibility criteria, and preoperative preparation, to the choice of surgical technique, postoperative care, management of complications, and revisional procedures. The document also includes guidance on pharmacological treatment as an addition or alternative to surgery, and addresses the needs of specific patient groups, such as pediatric patients, elderly individuals, women of reproductive age, and those with comorbid conditions. The aim of this update is to provide Polish patients with access to safe, effective, and evidence‑based treatment for obesity, while also aligning the health care system with the growing public health challenge posed by the obesity epidemic.