Role of the gastroenterologist in the comprehensive management of people living with obesity. SEPD Position Paper

Obesity represents the most prevalent chronic metabolic disease and one of the greatest healthcare and social challenges of our time. Its close association with multiple digestive disorders-including metabolic dysfunction-associated steatotic liver disease (MASLD), various digestive cancers, inflammatory bowel disease, and gastroesophageal reflux disease-positions the gastroenterologist as a key actor in its detection, stratification, and comprehensive management. The SEPD position statement underscores the need to move beyond a complication-centered approach and to establish the gastroenterology consultation as a privileged entry point for the care of individuals living with obesity. SEPD advocates for a digestive-centered framework that integrates prevention, advanced diagnostics, pharmacological therapies, endoscopy, and surgery within a continuum of care led by gastroenterologists. Distinctively, the position statement incorporates metabolic endoscopy as a minimally invasive and cost-effective alternative, serving as a bridge between pharmacological treatment and surgery-an area in which Spanish gastroenterologists have developed recognized expertise and international leadership. It also promotes a stigma-free approach, calling for respectful and equitable language as part of the society's explicit ethical commitment. Furthermore, SEPD emphasizes the importance of real-world registries focused on digestive outcomes, fostering collaborative research and the generation of evidence applicable to both clinical practice and health policy. Taken together, this document reaffirms SEPD's clinical, scientific, and social commitment in the fight against obesity, advancing an innovative, person-centered, interdisciplinary, and humanistic approach aimed at transforming healthcare delivery and decisively contributing to the improvement of digestive and overall population health.