Obesity in Adults (2015)

    Full Guidelines

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    Endorsements

    College of Family Physicians of Canada

    This Clinical Practice Guideline has been endorsed by the College of Family Physicians of Canada.

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    Summary of recommendations for clinicians and policy-makers

    The CTFPHC will continue to carefully monitor the scientific developments in the prevention and management of obesity and report back to Canadians within 5 years with an update of the 2015 guidelines.

     

    Recommendations

    Measurement of BMI

    These recommendations apply to apparently healthy adults ≥ 18 years of age who present to primary care. These recommendations do not apply to people with eating disorders, or who are pregnant.

    • We recommend measuring height, weight and calculating BMI1 at appropriate2 primary care visits.
      (Strong recommendation; very low quality evidence)

    Prevention of weight gain

    These recommendations do not apply to people with eating disorders, or who are underweight, pregnant, overweight or obese (Body Mass Index [BMI] ≥ 25).

    • We recommend that practitioners not offer formal, structured interventions3 aimed at preventing weight gain in normal weight adults.
      (Weak recommendation; very low quality evidence)

    Management of overweight and obesity

    These recommendations apply to adults ≥ 18 years of age who are overweight or obese (25 ≤ BMI < 40). Pregnant women and people with health conditions where weight loss is inappropriate are excluded. These guidelines do not apply to people with BMI ≥ 40, who may benefit from specialized bariatric programs.

    • For adults who are obese (30 ≤ BMI < 40) and are at high risk of diabetes4, we recommend that practitioners offer or refer to structured behavioural interventionsiii aimed at weight loss.
      (Strong recommendation; moderate quality evidence)
    • For adults who are overweight or obese, we recommend that practitioners offer or refer to structured behavioural interventions5 aimed at weight loss.
      (Weak recommendation; moderate quality evidence)
    • For adults who are overweight or obese, we recommend that practitioners not routinely offer pharmacologic interventions (orlistat or metformin) aimed at weight loss6.
      (Weak recommendation; moderate quality evidence)

     

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