Assessing the state of obesity care: Quality, access, guidelines, and standards

Author:

Kaplan Lee M.1ORCID,Apovian Caroline M.2ORCID,Ard Jamy D.3ORCID,Allison David B.4,Aronne Louis J.5ORCID,Batterham Rachel L.67ORCID,Busetto Luca8,Dicker Dror9,Horn Deborah B.10,Kelly Aaron S.11,Mechanick Jeffrey I.1213,Purnell Jonathan Q.14,Ramos‐Salas Ximena15,

Affiliation:

1. Obesity, Metabolism and Nutrition Institute Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USA

2. Division of Endocrinology, Diabetes, Nutrition and Weight Management Nutrition and Weight Management Center Boston Medical Center and Boston University School of Medicine Boston Massachusetts USA

3. Department of Epidemiology and Prevention Wake Forest University School of Medicine Winston‐Salem North Carolina USA

4. Department of Epidemiology and Biostatistics Indiana University School of Public Health‐Bloomington Bloomington Indiana USA

5. Department of Medicine Weill‐Cornell College of Medicine New York New York USA

6. Department of Medicine Centre for Obesity Research Rayne Institute University College London London UK

7. National Institute for Health and Care Research University College London Hospitals Biomedical Research Centre London UK

8. Department of Medicine University of Padova Padova Italy

9. Department of Internal Medicine D Haharon Hospital Rabin Medical Center Sackler School of Medicine Tel Aviv University Tel Aviv Israel

10. Center for Obesity Medicine and Metabolic Performance University of Texas McGovern Medical School Houston Texas USA

11. Department of Pediatrics and Center for Pediatric Obesity Medicine University of Minnesota Minneapolis Minnesota USA

12. Marie‐Josée and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart New York New York USA

13. Metabolic Support Division of Endocrinology, Diabetes and Bone Disease Icahn School of Medicine at Mount Sinai New York New York USA

14. Division of Endocrinology, Diabetes, and Clinical Nutrition Knight Cardiovascular Institute Oregon Health & Science University Portland Oregon USA

15. Obesity Canada Edmonton Alberta Canada

Abstract

AbstractBackgroundAn international panel of obesity medicine experts from multiple professional organizations examined patterns of obesity care and current obesity treatment guidelines to identify areas requiring updating in response to emerging science and clinical evidence.AimsThe panel focused on multiple medical health and societal issues influencing effective treatment of obesity and identified several unmet needs in the definition, assessment, and care of obesity.MethodsThe panel was held in Leesburg, Virginia in September 2019.ResultsThe panelists recommended addressing these unmet needs in obesity medicine through research, education, evaluation of delivery and payment of care, and updating clinical practice guidelines (CPG) to better reflect obesity’s pathophysiological basis and heterogeneity, as well as the disease’s health, sociocultural, and economic complications; effects on quality of life; need for standards for quantitative comparison of treatment benefits, risks, and costs; and the need to more effectively integrate obesity treatment guidelines into routine clinical practice and to facilitate more direct clinician participation to improve public understanding of obesity as a disease with a pathophysiological basis. The panel also recommended that professional organizations working to improve the care of people with obesity collaborate via a working group to develop an updated, patient‐focused, comprehensive CPG establishing standards of care, addressing identified needs, and providing for routine, periodic review and updating.ConclusionsUnmet needs in the definition, assessment and treatment of obesity were identified and a blueprint to address these needs developed via a clinical practice guideline that can be utilized worldwide to respond to the increasing prevalence of obesity.

Funder

Novo Nordisk

Publisher

Wiley

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