Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


ACP guidelines to treat obesity cover diet, exercise, drugs and surgery


New guidelines for management of obesity from the American College of Physicians recommend diet and exercise for everyone and drugs and surgery only for obese patients who are not able to achieve weight-loss goals with diet and exercise alone. The guidelines, "Pharmacologic and Surgical Management of Obesity in Primary Care: A Clinical Practice Guideline from the American College of Physicians," were published in the April 5, 2005, issue of Annals of Internal Medicine.

People with a body mass index (BMI) over 30 might consider drug therapy after an appropriate trial of diet and exercise has failed. Surgery is for those with a BMI over 40 who also have obesity-related health problems such as high blood pressure, diabetes, or sleep apnea, ACP guidelines say.

People with a body mass index from 25-29.9 are considered overweight. Those with BMI from 30-39.9 are considered obese; people with a BMI over 40 are considered morbidly (or extremely) obese. BMI is a measure of height and weight. ACP’s new guidelines apply to patients with BMI’s of 30 and over.

"BMI should be considered another vital sign," says Vincenza Snow, MD, director of clinical programs at ACP. "Patients should know their BMIs like they know their age, blood pressure and cholesterol numbers, and doctors should track their patients’ BMIs like they follow blood pressure."

Weight-Loss Drugs

ACP identifies six drugs that according to valid clinical studies aid weight loss: sibutramine, orlistat, phentermine, diethylproprion, and fluxotine. When patients and clinicians are making decisions about use of these drugs, ACP recommends frank discussions about potential side effects and lack of long-term efficacy and safety data. (Most weight-loss drugs have no studies beyond one year.) Further, the average weight loss at one year is small to moderate, ACP says, and there are no data on whether weight loss is maintained after drug therapy is discontinued.

"Even with weight-loss drugs and even after surgery, patients must change lifestyles, eat properly and exercise," says Snow. "There’s no magic bullet."

Bariatric Surgery

ACP guidelines discuss several types of obesity (bariatric) surgical procedures and cautions that none have randomized, controlled trials comparing surgery with non-surgical control groups. Furthermore, all have possible side effects, ranging from surgical complications to gall bladder disease and digestion difficulties. The ACP guidelines estimate that the death rate from bariatric surgery, including in-hospital and deaths within 30 days of discharge, ranges from 0.3 in a hundred to as high as 1.9 per 100 surgeries.

ACP says that existing evidence shows a technical ’learning curve’ in bariatric surgical techniques and suggests that doctors and patients considering obesity surgery seek highly experienced surgeons and surgical centers whenever feasible.

"There are differences among the surgeries, so patients need to understand the risks of complications from surgery as well as complications further down the road, such as gall bladder disease and sometimes re-operation," said Snow.

ACP based its guidelines on an evidence report and background papers funded by the Agency for Healthcare Research and Quality. The guidelines were developed by ACP’s Clinical Efficacy Assessment Subcommittee and were passed by the ACP Board of Regents in October 2004.

Susan Anderson | EurekAlert!
Further information:

More articles from Health and Medicine:

nachricht Inflammation Triggers Unsustainable Immune Response to Chronic Viral Infection
24.10.2016 | Universität Basel

nachricht Resolving the mystery of preeclampsia
21.10.2016 | Universitätsklinikum Magdeburg

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Light-driven atomic rotations excite magnetic waves

Terahertz excitation of selected crystal vibrations leads to an effective magnetic field that drives coherent spin motion

Controlling functional properties by light is one of the grand goals in modern condensed matter physics and materials science. A new study now demonstrates how...

Im Focus: New 3-D wiring technique brings scalable quantum computers closer to reality

Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.

"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...

Im Focus: Scientists develop a semiconductor nanocomposite material that moves in response to light

In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.

A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...

Im Focus: Diamonds aren't forever: Sandia, Harvard team create first quantum computer bridge

By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.

"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...

Im Focus: New Products - Highlights of COMPAMED 2016

COMPAMED has become the leading international marketplace for suppliers of medical manufacturing. The trade fair, which takes place every November and is co-located to MEDICA in Dusseldorf, has been steadily growing over the past years and shows that medical technology remains a rapidly growing market.

In 2016, the joint pavilion by the IVAM Microtechnology Network, the Product Market “High-tech for Medical Devices”, will be located in Hall 8a again and will...

All Focus news of the innovation-report >>>



Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

Agricultural Trade Developments and Potentials in Central Asia and the South Caucasus

14.10.2016 | Event News

World Health Summit – Day Three: A Call to Action

12.10.2016 | Event News

Latest News

Enormous dome in central Andes driven by huge magma body beneath it

25.10.2016 | Earth Sciences

First time-lapse footage of cell activity during limb regeneration

25.10.2016 | Life Sciences

Deep down fracking wells, microbial communities thrive

25.10.2016 | Earth Sciences

More VideoLinks >>>