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

ID: 
38
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Organisation Name: 
Population Health, Department of Health and Human Services
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No
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National Health and Medical Research Council

Management of Overweight and Obesity in Adults, Adolescents and Children

Clinical Practice Guidelines for Primary Care Health Professionals

Public Consultation Draft – 29 March 2012

 

Submission from Population Health, Department of Health and Human Services Tasmania

Thank you for the opportunity to comment on the Management of Overweight and Obesity in Adults, Adolescents and Children: Clinical Practice Guidelines for Primary Care Health Professionals (the Guidelines), Public Consultation Draft – 29 March 2012.  This submission has been compiled on behalf of Population Health in the Department of Health and Human Services, Tasmania.

The guidelines provide a valuable tool for primary care health professionals to help guide consistent practice that is based on sound scientific evidence.  We are impressed with the professional way the guidelines have been developed and believe they are a clear and concise summary of the extensive evidence-based review.  We appreciate the enormity of the task involved in synthesising the literature on the management of obesity and overweight and congratulate those involved in this task. 

This is an extremely brief submission but we would like to raise the issue of the scope of the review and its associated conclusion and guidelines.

  • This piece of work has focussed on managing overweight and obesity with the primary end-point being weight loss – with the conclusion that for many individuals in our society weight gain is hard to avoid and difficult to reverse. 
  • This conclusion suggests it may be time to consider reframing obesity (and perhaps overweight) as a chronic condition requiring ongoing management and focus on associated complications and health risks. 
  • The public consultation draft of the Guidelines states that overweight and obese people experience other co-morbidities (summarised on page 13 in section 4.3.1 of) and are exposed to higher risks of a range of health conditions (summarised in Table 5.1). 
  • Given the difficulty in reversing overweight and obesity in many individuals it may be prudent, as a next step, for NHMRC to consider guidelines that describe  ‘how to best manage the health of individuals that are overweight or obese and in whom weight loss is unlikely?’  This question would lead to quite a different clinical practice guideline.

We are pleased to see the table in section 4.3 which identifies considerations in interpretation of the BMI, and the use of waist circumference to be used in addition to BMI to refine assessment of metabolic risk rather than in isolation.  These measures are at risk of being used and interpreted inappropriately and we feel this advice will assist in these measures being used more responsibly.

Thank you again for the opportunity to comment.

Page reviewed: 6 September, 2012