New obesity guidelines underscore multifaceted approach

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Takeaway

  • The guidelines outline how to develop a comprehensive plan for the real-world management of obesity, including screening, diagnosis, evaluation, selection of therapy, treatment goals, and individualization of care.

Key results

  • The guidelines were jointly developed by the American Association of Clinical Endocrinologists and the American College of Endocrinology.
  • They address 9 clinical questions with 123 numbered recommendations and 160 specific statements.
  • Overall, 53.1% of the statements are strong (Grade A), 30.0% are intermediate (Grade B), 6.9% are weak (Grade C), and 10.0% are based on expert opinion (Grade D).
  • 83.1% of statements are based on strong or intermediate levels of scientific substantiation, defined as a best evidence level of 1 or 2.
  • The guidelines endorse obesity as a complex, adiposity-based chronic disease.
  • Optimal management targets both the adiposity and weight-related complications to improve patients’ overall health and quality of life.

Study design

  • A systematic review of the evidence on management of obesity.
  • Statements were rated according to the best evidence level system and assigned grades.

Limitations

  • The are gaps in the evidence, and included studies had some shortcomings.
  • References are limited to those key to each recommendation.
  • The guidelines are not exhaustive but rather intended to complement other guidelines on topics such as physical activity and healthy eating.
  • Some of the authors have relationships with pharmaceutical companies.

Why this matters

  • Obesity is an increasingly prevalent health condition associated with considerable morbidity.
  • More surgical and medical treatment options for obesity have become available over time.