personal fees from Sanofi outside the submitted work. AT is currently an employee of Novo Nordisk. This work was performed before AT became a Novo Nordisk employee and Novo Nordisk had no role in this project. Kamal Mahawar has been paid honoraria by Ethicon, Medtronic, Gore, Olympus, and various NHS trusts for educationa l activities and mentoring colleagues through One Anastomosis Gastric Bypass. The other authors declare that they have no conflicts of interest. 4 Global variations in preoperative practices concerning patients seeking primary bariatric and metabolic surgery (PACT Study