Obesity in Adults (2015)

Summary of recommendations for clinicians and policy-makers

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 BMI at appropriate 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 interventions 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 diabetes, we recommend that practitioners offer or refer to structured behavioural interventions 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 interventions 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 loss.
  (Weak recommendation; moderate quality evidence)