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Revised draft Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, Children and Adolescents

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Specific questions
Question 2: What would help you implement these recommendations into practice?: 

These guidelines need to be widely distributed and mandatory reading for dieticians within hospitals.

There needs to be increased discussion about risk benefit analysis for morbidly obese patients undergoing surgery and patients need far better information regarding the risks involved and the alternative strategies prior to surgery.

Introduction of multidisciplinary clinics for weight loss within public hospitals would be helpful.

Every patient admitted to hospital should have a BMI recorded and if high then this should trigger a dietician referral, introduction of an appropriate reduction diet, advice about the disease (in the form of pamphlets or information on TV) and advice regarding strategies for weight loss and local services available.

Specific comments
General comments

The problem of obesity has been increasing for at least 20 years and despite widespread discussion on the subject there has been no reduction in numbers. As noted in the guidelines the problem is complex and extremely difficult to address given that food is plentiful and that the type of food that is most commonly consumed is obesogenic. In combination with this, exercise has become almost a luxury and is not a factor in daily life for most people.

It seems unlikely that more guidelines will be effective and therefore more robust means of treating the problem are required.

Admission to hospital is a perfect opportunity to address the issue and to introduce dietary limitations and to organize exercise programmes.

Deferral of surgery until a desired weight is achieved would give a significant incentive to weight loss and would have the benefit of reducing complications of surgery.

Other governmental options might include limiting restaurants from "All you can eat" offers and even perhaps legislating how much meat is allowed in a serving. It is increasingly clear that animal factory farming contributes greatly to green house gases and is also an issue for those who are concerned about animal welfare. 

Page reviewed: 6 September, 2012