European Practical and Patient-Centred Guidelines for Adult Obesity Management in Primary Care

Obes Facts. 2019;12(1):40-66. doi: 10.1159/000496183. Epub 2019 Jan 23.

Abstract

The first contact for patients with obesity for any medical treatment or other issues is generally with General Practitioners (GPs). Therefore, given the complexity of the disease, continuing GPs' education on obesity management is essential. This article aims to provide obesity management guidelines specifically tailored to GPs, favouring a practical patient-centred approach. The focus is on GP communication and motivational interviewing as well as on therapeutic patient education. The new guidelines highlight the importance of avoiding stigmatization, something frequently seen in different health care settings. In addition, managing the psychological aspects of the disease, such as improving self-esteem, body image and quality of life must not be neglected. Finally, the report considers that achieving maximum weight loss in the shortest possible time is not the key to successful treatment. It suggests that 5-10% weight loss is sufficient to obtain substantial health benefits from decreasing comorbidities. Reducing waist circumference should be considered even more important than weight loss per se, as it is linked to a decrease in visceral fat and associated cardiometabolic risks. Finally, preventing weight regain is the cornerstone of lifelong treatment, for any weight loss techniques used (behavioural or pharmaceutical treatments or bariatric surgery).

Keywords: Bariatric/metabolic surgery; Behavioural therapy; Conservative treatment; GPs; Management; Motivational interviewing; Obesity; Overweight; Primary care.

MeSH terms

  • Adult
  • Comorbidity
  • Europe / epidemiology
  • General Practitioners / organization & administration
  • General Practitioners / standards
  • Humans
  • Obesity / epidemiology
  • Obesity / therapy*
  • Obesity Management / methods
  • Obesity Management / organization & administration
  • Obesity Management / standards*
  • Patient-Centered Care / standards*
  • Practice Guidelines as Topic*
  • Primary Health Care / standards*
  • Quality of Life
  • Waist Circumference
  • Weight Loss