Meet the Adult COMs – MBAL, Sveta Sofia, Bulgaria

This edition of Meet the COMs features MBAL “Sveta Sofia”, an Adult COM based in Sofia, Bulgaria. Led by Dr. Konstantin Grozdev and Professor Teodora Handjieva-Darlenska, this COM comprises a multidisciplinary team of endocrinologists, a cardiologist, a dietitian, a bariatric surgeon, a psychiatrist, a psychologist, and a sleep apnea specialist. Together, they provide comprehensive obesity care using a holistic, patient-centred approach. Their COM services encompass surgical interventions, medical assessments based on metabolic and cardiac status, medical nutrition therapy, psychological evaluation and counselling, and pharmacotherapy. MBAL “Sveta Sofia” also offers a Laparoscopic Metabolic Surgery Course to train surgeons in this field. In addition to their roles within the COM, Dr. Grozdev serves as the President of the Bulgarian Society for Bariatric/ Metabolic Surgery, while Prof. Handjieva-Darlenska is the President of the Bulgarian Association for the Study of Obesity and Related Diseases.

Welcome! What have been some of the key achievements and updates from your COM in the past year?
Over the past 12 months, our COM has actively participated in campaigns focused on raising awareness of obesity as a chronic and relapsing disease. We have worked closely with the Bulgarian Association for Patients Living with Obesity and the Bulgarian Association for the Study of Obesity and Related Diseases to educate both healthcare professionals and the general public. Our team members also regularly attend the European Congress on Obesity (ECO) to stay informed on the latest developments in obesity research and treatment.

What is your COM’s approach to patient care? How do you measure patient satisfaction and outcomes?
We follow a patient-centred approach, ensuring that people living with obesity are at the core of our therapeutic pathway. Acknowledging their feelings, challenges, and motivations is a key part of our care model. Obesity is a chronic disease requiring long-term support, so we have implemented a five-year follow-up program to assess patients’ medical and psychological status regularly. This allows us to monitor progress and adjust treatment plans as needed.

Thank you. In terms of staff, how does your COM attract and retain top talent? Do you offer specialised training opportunities to your COM multidisciplinary team?
We attract and retain top professionals by offering teamwork opportunities, modern treatments based on the latest obesity management guidelines, academic development pathways, and competitive salaries. Through various media channels, we also promote awareness about obesity and its treatment and the activities of our team. Team members also have many opportunities to engage with European obesity research and training opportunities. For example, Dr. Peter Ivanov attended the EASO COM Summit in November 2024 in Santiago de Compostela, Spain. As a PhD student with a special interest in body composition and new anthropometric measurements in obesity, he actively contributes to our research and clinical practice. We also strongly encourage our early career team members to engage with the EASO Early Career Network (ECN) to enhance their professional development and build their network within the obesity community.

Does your COM engage with the wider community in obesity awareness, prevention, and treatment?
Yes, we collaborate closely with the Bulgarian Association for Patients Living with Obesity, the Bulgarian Association for the Study of Obesity and Related Diseases, and the Bulgarian Society for Bariatric/ Metabolic Surgery. Through these partnerships, we work to raise awareness, provide support, and promote evidence-based obesity management strategies.

What are the biggest challenges your COM currently faces? What are your main goals for the next 3-5 years?
One of our biggest challenges is that obesity treatments, including medical counselling, pharmacotherapy, and bariatric/metabolic surgery, are not covered by the Bulgarian health system. This makes access to treatment difficult for many patients due to high costs. Additionally, while technology is becoming increasingly important in obesity management, we are still exploring ways to integrate telemedicine and artificial intelligence into our practice. Looking ahead, we aim to establish collaborations with other COMs and institutions across Europe, participate in pan-European scientific projects, and publish research papers to contribute to the field of obesity management.

Thank you to Dr. Konstantin Grozdev, Professor Teodora Handjieva-Darlenska, and the entire team at MBAL “Sveta Sofia” for participating in the Meet the COMs initiative and for their dedication to comprehensive, multidisciplinary obesity care. Despite challenges such as limited health system coverage for obesity treatments, this team is commitment to advancing obesity management through awareness campaigns, professional training, and international collaboration. With a strong focus on expanding research, forging European partnerships, and enhancing patient care, MBAL “Sveta Sofia” continues to improve obesity treatment and advocacy in Bulgaria.