Condition or domain being studied Obesity; Severe Obesity; Body Mass Index 40+ - Severely Obese Obesity is a chronic condition in which increased body fat promotes adipose tissue dysfunction and metabolic consequences. Traditionally, obesity is characterized by the presence of a body mass index (BMI) 30 kg/m2 (variable definition, according to ethnic/genetic factors) and severe obesity definition encompasses people living with a BMI40kg/m2. Clinical practice guidelines (CPGs) are supposed to state the best recommendations to assist well informed decisions in health care context. As overall mortality has an almost linear relationship with BMI in obese patients, we aim to sistematically review the literature in order to summarize and assess the CPGs regarding severe obesity and to search for specific clinical practice guideline recommendations (CPGRs) for very high-risk obese patients (BMI?_50kg/m2). Rationale for the review Obesity is defined as a status in which the individual body weight is above the recommended standard (usually BMI30kg/m2 or 25kg/m2 in Asian population). Severe obesity (previously know as morbid obesity) is a subclassification characterized by BMI40 kg/m2. Individuals with a BMI50 kg/m2 (eventually classified as people with super-obesity) represent a group of high-risk patients often underrepresented in clinical trials and observational studies. We aim to summarize, critically assess and identify gaps in current clinical practice guidelines for management of severe obesity and specifically to summarize, critically assess and identify gaps on recommendations for clinical management of people with BMI50kg/m2. All the interventions mentioned in the retrieved guidelines will be accounted (behavioral, nutritional, surgical or pharmacological interventions). Review objectives Question: What are the recommendations for the clinical management of very high-risk severely obese patients (BMI50kg/m2) on different clinical practice guidelines (CPGs) for obesity? Aim: This review aims to identify the CPGs for severe obesity patients and summarize and assess the recommendations (CPGRs) for the clinical management of very-high-risk obese patients (BMI50kg/m2). Specific aims: • To describe and analyze the scope of eligible CPGs content: target population and domains covered; • To assess the methodological quality of CPGs for severe obesity management; • To identify CPGs with at least one evidence-based recommendation for the management of very high-risk severe obesity patients subpopulation (BMI50kg/m2); • To summarize the recommendations of the included guidelines; • To examine the consistency of CPGRs for very-high risk severe obese patients (BMI50kg/m2); • To identify and compare CPGRs regarding pre-bariatric surgery intervention for very high-risk obese patients (BMI50kg/m2).