Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

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

05.04.2005


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:
http://www.acponline.org
http://www.annals.org.

More articles from Health and Medicine:

nachricht On track to heal leukaemia
18.01.2017 | Universitätsspital Bern

nachricht Penn vet research identifies new target for taming Ebola
12.01.2017 | University of Pennsylvania

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: How gut bacteria can make us ill

HZI researchers decipher infection mechanisms of Yersinia and immune responses of the host

Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...

Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

Im Focus: How to inflate a hardened concrete shell with a weight of 80 t

At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).

Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

Nothing will happen without batteries making it happen!

05.01.2017 | Event News

 
Latest News

A big nano boost for solar cells

18.01.2017 | Power and Electrical Engineering

Glass's off-kilter harmonies

18.01.2017 | Materials Sciences

Toward a 'smart' patch that automatically delivers insulin when needed

18.01.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>