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

ID: 
40
Personal Details
Organisation Name: 
Physical Activity, Nutrition & Obesity Research Group
Additional Information
In regard to your comments, do you have a Conflict of Interest to disclose?: 
No
Specific questions
Question 2: What would help you implement these recommendations into practice?: 

A decision-making tool for when a patient is in front of a practitioner - enabling quick determination of provision of lifestyle advice, setting of weight goals, referral to intervention (e.g. local programs) and/or allied health support, and/or treatment appropriate to the BMI, age, stage of life, readiness to change lifestyle behaviours

The recommendations are currently written from an intervention perspective rather than an application/practice perspective

Specific comments
Comments: 
Summary of recommendations

Although there is mention about weight management of pregnant women in the body of the draft guidelines - they are mentioned as requiring tailored interventions - there is no specific mention of weight gain advice for pregnant women in the recommendations

Pregnancy is an opportune time in which health practitioners can intervene in terms of weight status (short-term and long-term health benefits to mother, long-term prevention of overweight/obesity in child and mother) - monitoring of weight throughout pregnancy and the provision of lifestyle advice and recommendations regarding weight gain during pregnancy is prudent and should be considered as a particular recommendation.

Pregnancy is distinct from other life stages as it is not just related to a particular age but a highly specific 'condition' very relevant to weight management.

Summary of recommendations

There is no mention of referrals in the recommendations yet referral for lifestyle advice and intervention is a necessary component of weight management, particularly for the high at-risk, existing chronic disease persons

6.4 Tailoring weight management programs to specific population groups

The current draft guidelines do not indicate whether practitioners should adopt the IOM guidelines in communicating weight gain advice to pregnant women - the NHMRC guidelines need to indicate to practitioners that weight gain advice (and what that weight gain advice should be, i.e. IOM recommendations) should be effectively communicated to all pregnant women (regardless of pre-pregnancy BMI) early in pregnancy and ongoing weighing and advice concerning weight gain part of routine care

General comments
Comments: 
  • Although the document is listed as 'Guidelines' there is then a set of recommendations...it is not clear then what the Guidelines really are....what is the difference between Guidelines and Recommendations? It would be good to be explicit regarding interpretation and application of these terms
  • The Guidelines themselves are long - and it is not clear as to what is the purpose of the entirety of the Guidelines.
  • A briefer version of the guidelines for practitioners would be useful, including a decion-making tool to apply the recommendations more practically (i.e. what advice, referrals, treatment) depending on patient BMI, lifestage, existing chronic disease, readiness to change behaviour.
  • This could simply be achieved by re-writing the recommendations from a practice perspective, i.e. the course of action by practitioner based on the presenting patient's BMI, existing chronic disease(s)/risk factors, and lifestage (e.g. pregnancy, adolescence); rather than the current version of the recommendations which are based on the intervention/treatment

Page reviewed: 6 September, 2012