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 Another reason to exercise: Burning bone fat -- a key to better bone health
19.05.2017 | University of North Carolina Health Care

nachricht Disrupted fat breakdown in the brain makes mice dumb
19.05.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

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: Wafer-thin Magnetic Materials Developed for Future Quantum Technologies

Two-dimensional magnetic structures are regarded as a promising material for new types of data storage, since the magnetic properties of individual molecular building blocks can be investigated and modified. For the first time, researchers have now produced a wafer-thin ferrimagnet, in which molecules with different magnetic centers arrange themselves on a gold surface to form a checkerboard pattern. Scientists at the Swiss Nanoscience Institute at the University of Basel and the Paul Scherrer Institute published their findings in the journal Nature Communications.

Ferrimagnets are composed of two centers which are magnetized at different strengths and point in opposing directions. Two-dimensional, quasi-flat ferrimagnets...

Im Focus: World's thinnest hologram paves path to new 3-D world

Nano-hologram paves way for integration of 3-D holography into everyday electronics

An Australian-Chinese research team has created the world's thinnest hologram, paving the way towards the integration of 3D holography into everyday...

Im Focus: Using graphene to create quantum bits

In the race to produce a quantum computer, a number of projects are seeking a way to create quantum bits -- or qubits -- that are stable, meaning they are not much affected by changes in their environment. This normally needs highly nonlinear non-dissipative elements capable of functioning at very low temperatures.

In pursuit of this goal, researchers at EPFL's Laboratory of Photonics and Quantum Measurements LPQM (STI/SB), have investigated a nonlinear graphene-based...

Im Focus: Bacteria harness the lotus effect to protect themselves

Biofilms: Researchers find the causes of water-repelling properties

Dental plaque and the viscous brown slime in drainpipes are two familiar examples of bacterial biofilms. Removing such bacterial depositions from surfaces is...

Im Focus: Hydrogen Bonds Directly Detected for the First Time

For the first time, scientists have succeeded in studying the strength of hydrogen bonds in a single molecule using an atomic force microscope. Researchers from the University of Basel’s Swiss Nanoscience Institute network have reported the results in the journal Science Advances.

Hydrogen is the most common element in the universe and is an integral part of almost all organic compounds. Molecules and sections of macromolecules are...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Dortmund MST Conference presents Individualized Healthcare Solutions with micro and nanotechnology

22.05.2017 | Event News

Innovation 4.0: Shaping a humane fourth industrial revolution

17.05.2017 | Event News

Media accreditation opens for historic year at European Health Forum Gastein

16.05.2017 | Event News

 
Latest News

New approach to revolutionize the production of molecular hydrogen

22.05.2017 | Materials Sciences

Scientists enlist engineered protein to battle the MERS virus

22.05.2017 | Life Sciences

Experts explain origins of topographic relief on Earth, Mars and Titan

22.05.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>