Management of overweight and obesity in primary care-A systematic overview of international evidence-based guidelines

Thomas Semlitsch, Florian L Stigler, Klaus Jeitler, Karl Horvath, Andrea Siebenhofer, Thomas Semlitsch, Florian L Stigler, Klaus Jeitler, Karl Horvath, Andrea Siebenhofer

Abstract

Overweight and obesity are increasing worldwide. In general practice, different approaches exist to treat people with weight problems. To provide the foundation for the development of a structured clinical pathway for overweight and obesity management in primary care, we performed a systematic overview of international evidence-based guidelines. We searched in PubMed and major guideline databases for all guidelines published in World Health Organization (WHO) "Stratum A" nations that dealt with adults with overweight or obesity. Nineteen guidelines including 711 relevant recommendations were identified. Most of them concluded that a multidisciplinary team should treat overweight and obesity as a chronic disease. Body mass index (BMI) should be used as a routine measure for diagnosis, and weight-related complications should be taken into account. A multifactorial, comprehensive lifestyle programme that includes reduced calorie intake, increased physical activity, and measures to support behavioural change for at least 6 to 12 months is recommended. After weight reduction, long-term measures for weight maintenance are necessary. Bariatric surgery can be offered to people with a BMI greater than or equal to 35 kg/m2 when all non-surgical interventions have failed. In conclusion, there was considerable agreement in international, evidence-based guidelines on how multidisciplinary management of overweight and obesity in primary care should be performed.

Keywords: adults; obesity; overweight; systematic overview.

Conflict of interest statement

This manuscript is based on the report “(Be‐)Handlungspfad Übergewicht & Adipositas auf Primärversorgungsebene, Version 1.2; 2016,” which was funded by the Main Association of Austrian Social Security Institutions (http://www.hauptverband.at). None of the authors have conflicts of interest to declare.

© 2019 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.

Figures

Figure 1
Figure 1
Flow chart of guideline selection process

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