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

ID: 
46
Personal Details
First Name: 
Stephen
Last Name: 
Colagiuri
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 specific implementation plan supported by dedicated and adequate funding

Specific comments
Comments: 
4.3 Other factors in assessment of health risk in adults

Cardiovascular risk assessment

Table 4.6 and the section on CVD risk assessment is not consistent with the recently approved NHMRC Guidelines for the Management of Absolute Disease Risk developed by the National Vascular Disease Prevention Alliance (NVDPA). The table should be replaced by the relevant section in the above guideline. Essentially all people aged 45 and over (35 and over for Aboriginal and Torres Strait Islanders) without a previous CVD event should have a CVD risk assessment – some conditions are identified as being at clinically high risk, for the remaining people CVD risk should be assessed using the Framingham Risk Equation

The information in the above table is not consistent with the current PP.

Details of the NHMRC endorsed risk assessment have been sent in a separate submission from NVDPA.  

5.2 Explaining the benefits of lifestyle change and weight loss

Recommendation 4 states “Advise adults who are overweight or obese that modest weight loss reduces cardiovascular risk” and is graded A.

The evidence supports Grade A for an effect on risk factors rather than risk per se and consideration should be given to rewording to the recommendation to “cardiovascular risk factors” in order to support a Grade A recommendation.

Introduction

Costing data - Page xi 

Consideration should be giving to adding that the cost of overweight, not just obesity, is substantial. Our group has published an analysis of the AusdDiab data which reported that in 2005 the total direct cost for overweight and obesity was $21 billion ($6.5 billion for overweight and $14.5 billion for obesity.(Colagiuri S, Lee CM, Colagiuri R, Cameron A, Shaw J, Zimmet, P, Caterson ID. The cost of overweight and obesity in Australia. MJA 2010; 192 (5): 260-264).

Page reviewed: 6 September, 2012