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Obesity for Adults, Prevention and Management of

Guideline Summary

Revision Date: May 2013
Sixth Edition

Scope and Target Population

This guideline addresses the prevention, diagnosis and management of obesity in adult patients, and includes behavioral approaches, drug treatment and surgery.

This guideline does not address pregnant women or bodybuilders/weight trainers.

Aims

  1. Increase percentage of patients 18 years and older who have an annual screening for obesity using body mass index (BMI) measure specific for age and gender.
  2. Increase the percentage of patients age 18 years and older with BMI > 25 kg/m2 who have received education and counseling regarding weight management.
  3. Increase the percentage of patients age 18 years and older with BMI > 25 who have improved outcomes from the treatment.

Clinical Highlights

  • Obesity is a chronic disease that is a multifactorial, growing epidemic with complex political, social, psychological, environmental, economic and metabolic causes and consequences. Obesity affects essentially every organ system in the body. Health consequences increase across the body mass index span, not just for the extremely obese.
  • Calculate the body mass index; classify the individual based on the body mass index categories. Educate patients about their body mass index and their associated risks.
  • Effective weight management strategies are available and include nutrition, physical activity, lifestyle changes, medication and surgery.
  • A 5-10% weight loss can reduce a patient's risk of heart disease and diabetes that is clinically significant, and should be encouraged for all patients who are overweight and obese. This amount of weight loss and maintenance should be considered a clinical success and commended. This can be achieved and maintained with a high-intensity medical weight loss program even for the morbidly obese.
  • The clinician should follow the 5 A's (Ask, Advise, Assess, Assist, Arrange). Physician intervention can be effective, the clinician can have an important influence, and successful weight management is possible.
  • Weight management requires a team approach. Be aware of clinical and community resources. The patient needs to have an ongoing therapeutic relationship and follow-up with a health care team. Weight control is a lifelong commitment, and the health care team can assist with setting specific goals with the patient.
  • Beyond their clinical role, primary care clinicians should be aware of their roles as community leaders and public health advocates.