The concept of enhanced recovery after surgery (ERAS) has been widely applied in surgical practice. Bariatric and metabolic surgery has its complexity and particularity. It is necessary to develop the Chinese expert consensus on the ERAS principles in bariatric and metabolic surgery.

The Chinese expert consensus on enhanced recovery after surgery principles in bariatric and metabolic surgery (2021 edition) was built up based on the modified Delphi approach. We created a committee of 20 recognized experts in bariatric and metabolic surgery who were responsible for proposal, review and voting for the statements. The committee invited 56 bariatric and metabolic surgeons to vote on 42 statements concerning on ERAS with the total voters were 76 people. After two rounds of voting, the agreements amongst ≥70.0% were regarded as reaching consensus.

The agreement rate was less than 80% in 14 statements of the 42 statements in the first round voting. At the second round voting, no consensus was achieved in 6 statements. Thirty-six statements were considered achieving consensus.

Based on literature evidence and the specific situation of bariatric and metabolic surgery in China, the Chinese expert consensus on enhanced recovery after surgery principles in bariatric and metabolic surgery (2021 edition) was achieved. This expert consensus can be used as a reference for bariatric and metabolic surgeons in clinical practice.