Obesity treatment guidelines’ expert panel report highlights thorough review process

The comprehensive expert panel report that laid the foundation for the obesity treatment guidelines compiled by The Obesity Society, American Heart Association and the American College of Cardiology has been published in Obesity.

“These guidelines are backed by a systematic evidence review that took 5 years to conduct,” Donna Ryan, MD, co-chair of the writing committee, told Endocrine Today. “It was a meticulous review of the literature, with highly stringent selection criteria, to address five critical questions.”

Rather than offering physicians broad and practical aspects of obesity management, the report “once and for all” answers very specific questions with certainty, Ryan said. This is essential for a field with varying notions of best way to evaluate and treat obesity, she added.

Donna Ryan, MD

“It’s important to print the nearly-400 pages is to show everybody the evidence that supports these statements,” Ryan said. “Some of what really comes out of here are things we need to stop arguing about.”

The preface, written by journal editors, calls out key messages in these frequently discussed areas, including:

Who needs to lose weight?
What is the optimum level of weight loss?
Which diet is the most effective for weight loss?
Is diet and exercise the best way to lose weight?
How can weight loss be maintained?
Who should receive bariatric surgery?

The report demonstrates why the guidelines refute “magic diets” for weight loss, a topic that could be controversial, Ryan noted; the experts asserted that a negative energy balance is required.

It also explains what is beneath the reasoning that ideal BMI or weight should not be the marker for weight loss success. “We need to help people lose weight, and you can actually start to see some benefits in glycemic control with weight loss as little as 3%,” Ryan said.

Evidence revealed in the report around the efficacy of lifestyle interventions could have reimbursement implications, Ryan explained, and forward the conversation for electronic or web-based intervention alternatives for those who might not have in-person access.

The guidelines’ strong endorsement for bariatric surgery as a means to help those who really need to achieve benefits most due to their high health risks is also explained. Ryan said, “This points to the advances that have been made in efficacy and the safety.”

Ryan applauded the American Heart Association and the American College of Cardiology for bundling these guidelines with those for cholesterol, blood pressure and lifestyle and making it simple to consider all together; those who want to read more in depth can read the entire report, she added.

“Both are providing a good public service for our patients,” Ryan said. “One is to increase the importance of obesity management in the broader context of health promotion and disease prevention, and The Obesity Society is really putting it all out there because it’s such an important document.”

For more information:

Managing Overweight and Obesity in Adults - Guidelines, Full Report and Preface to the Full Report