title: Bariatric Surgery for Morbid Obesity: Tehran Obesity Treatment Study (TOTS) Rationale and Study Design.
abstract: BACKGROUND
  Obesity is a major health concern in the Middle East and worldwide. It is among the leading causes of morbidity, mortality, health care utilization, and costs. With bariatric surgery proving to be a more effective treatment option for overweight and obesity, the need for systematic assessment of different procedures and their outcomes becomes necessary. These procedures have not yet been described in detail in our region.
  
  
  OBJECTIVE
  We aim to undertake a prospective study evaluating and comparing several surgical bariatric procedures in an Iranian population of morbid obese patients presenting to a specialized bariatric center.
  
  
  METHODS
  In order to facilitate and accelerate understanding of obesity and its complications, the Tehran Obesity Treatment Study (TOTS) was planned and developed. This study is a longitudinal prospective cohort study in consecutive patients undergoing bariatric surgery. TOTS investigators use standardized definitions, high-fidelity data collection system, and validated instruments to gather data preoperatively, at the time of surgery, postoperatively, and in longer-term follow-up.
  
  
  RESULTS
  This study has recruited 1050 participants as of September 2015 and is ongoing.
  
  
  CONCLUSIONS
  This study will ensure creation of high-level evidence to enable clinicians to make meaningful evidence-based decisions for patient evaluation, selection for surgery, and follow-up care.
authors.affiliation: Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: Maryam
authors.identifier: http://orcid.org/0000-0001-7718-1952
authors.initials: M
authors.lastname: Barzin
authors.forename: Farhad
authors.identifier: http://orcid.org/0000-0001-5235-9451
authors.initials: F
authors.lastname: Hosseinpanah
authors.forename: Mohammad Ali
authors.identifier: http://orcid.org/0000-0003-4205-2848
authors.initials: MA
authors.lastname: Motamedi
authors.forename: Parvin
authors.identifier: http://orcid.org/0000-0002-2221-1269
authors.initials: P
authors.lastname: Shapoori
authors.forename: Peyman
authors.identifier: http://orcid.org/0000-0002-4071-9840
authors.initials: P
authors.lastname: Arian
authors.forename: Maryam Alsadat
authors.identifier: http://orcid.org/0000-0003-1525-8672
authors.initials: MA
authors.lastname: Daneshpour
authors.forename: Golale
authors.identifier: http://orcid.org/0000-0002-7925-5158
authors.initials: G
authors.lastname: Asghari
authors.forename: Ahmad
authors.identifier: http://orcid.org/0000-0003-3585-9256
authors.initials: A
authors.lastname: Teymoornejad
authors.forename: Ali
authors.identifier: http://orcid.org/0000-0002-8786-1676
authors.initials: A
authors.lastname: Eslamifar
authors.forename: Davood
authors.identifier: http://orcid.org/0000-0003-4956-1039
authors.initials: D
authors.lastname: Khalili
authors.forename: Behzad
authors.identifier: http://orcid.org/0000-0002-5227-0534
authors.initials: B
authors.lastname: Jodeiri
authors.forename: Shahram
authors.identifier: http://orcid.org/0000-0003-0894-6717
authors.initials: S
authors.lastname: Alamdari
authors.forename: Fereidoun
authors.identifier: http://orcid.org/0000-0002-7335-3873
authors.initials: F
authors.lastname: Azizi
authors.forename: Alireza
authors.identifier: http://orcid.org/0000-0001-5164-9406
authors.initials: A
authors.lastname: Khalaj
keywords: bariatric surgery; obesity; overweight; weight loss