Obesity in Adults: A 2022 Adapted Clinical Practice Guideline for Ireland.

Karl Neff, Caitríona O'Donnell, Sarah M O'Brien, Celine Murrin, Maura Murphy, Niamh Moran, Susan Moore, Fionnuala McAuliffe, Sean Manning, Sarah O'Dwyer, Dervla Kelly, Claire Kearney, Mary Hynes, Andrew Hogan, Helen Heneghan, Caroline Heary, Janas M Harrington, Anne Griffin, Cara O'Grada, Emer O'Malley, Orlaith O'Reilly, Sharleen O'Reilly, Olivia Porter, Helen M Roche, Amanda Rhynehart, Leona Ryan, Suzanne Seery, Corina Soare, Ferrah Shaamile, Abigail Walsh, Catherine Woods, Conor Woods, Ruth Yoder, Mark O'Kelly, Molly Byrne, Sarah Browne, Niamh Arthurs, Suzanne Allen, Mary Flynn, Oonagh Lyons, Clare O'Donovan, Grace O'Malley, Shauna Callaghan, Karen Gaynor, Louise Tully, Susie Birney, Donal O'Shea, Justin Geoghegan, Jean O'Connell, Cathy Breen, Carel W le Roux, Chris Collins, Aoife Courtney, Michael Crotty, Ciara Donohue, Caroline Donovan, Colin Dunlevy, Diarmuid Duggan, Naomi Fearon, Francis Finucane, Ita Fitzgerald, Siobhan Foy, John Garvey, Irene Gibson, Liam Glynn, Edward Gregg

Journal: Obesity facts 2022;15(6):736-752

PMID: 36279848

Free Full Text on S. Karger AG, Basel, Switzerland View on PubMed

Abstract

BACKGROUND

This Clinical Practice Guideline (CPG) for the management of obesity in adults in Ireland, adapted from the Canadian CPG, defines obesity as a complex chronic disease characterised by excess or dysfunctional adiposity that impairs health. The guideline reflects substantial advances in the understanding of the determinants, pathophysiology, assessment, and treatment of obesity.

SUMMARY

It shifts the focus of obesity management toward improving patient-centred health outcomes, functional outcomes, and social and economic participation, rather than weight loss alone. It gives recommendations for care that are underpinned by evidence-based principles of chronic disease management; validate patients' lived experiences; move beyond simplistic approaches of "eat less, move more" and address the root drivers of obesity.

KEY MESSAGES

People living with obesity face substantial bias and stigma, which contribute to increased morbidity and mortality independent of body weight. Education is needed for all healthcare professionals in Ireland to address the gap in skills, increase knowledge of evidence-based practice, and eliminate bias and stigma in healthcare settings. We call for people living with obesity in Ireland to have access to evidence-informed care, including medical, medical nutrition therapy, physical activity and physical rehabilitation interventions, psychological interventions, pharmacotherapy, and bariatric surgery. This can be best achieved by resourcing and fully implementing the Model of Care for the Management of Adult Overweight and Obesity. To address health inequalities, we also call for the inclusion of obesity in the Structured Chronic Disease Management Programme and for pharmacotherapy reimbursement, to ensure equal access to treatment based on health-need rather than ability to pay.

Address: Association for the Study of Obesity on the Island of Ireland, Dublin, Ireland.; Level 3 and 4 Obesity Services, St Columcille's and St Vincent's University Hospitals, Dublin, Ireland.; National Clinical Programme for Obesity, Dublin, Ireland.; Irish Coalition for People Living with Obesity, Dublin, Ireland.; Obesity Research and Care Group, School of Physiotherapy, Royal College of Surgeons Ireland, Dublin, Ireland.; Irish College of General Practitioners, Dublin, Ireland.; Food Safety Authority of Ireland, Dublin, Ireland.; Rehab Group, Dublin, Ireland.; School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin, Ireland.; School of Psychology,University of Galway, Galway, Ireland.; School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland.; Bariatric Medicine Service, Galway University Hospital, Galway, Ireland.; My Best Weight Healthcare Clinic, Dublin, Ireland.; Edenpark Medical, Raheny, Dublin, Ireland.; School of Agriculture and Food Science, University College Dublin, Dublin, Ireland.; Metabolic Surgery Service, Bons Secours Hospital, Cork, Ireland.; St Patricks University Hospital, Dublin, Ireland.; Collaborative Doctoral Programme in Chronic Disease Prevention, University of Galway, Galway, Ireland.; School of Medicine, University of Limerick, Limerick, Ireland.; School of Population Health, Royal College of Surgeons Ireland, Dublin, Ireland.; School of Allied Health, University of Limerick, Limerick, Ireland.; School of Public Health, University College Cork, Cork, Ireland.; Obesity Immunology Research Group, Maynooth University, Maynooth, Ireland.; Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland.; Department of Endocrinology, Cork University Hospital, Cork, Ireland.; School of Medicine, University College Dublin, Dublin, Ireland.; Department of Psychiatry, St Vincent's University Hospital, Dublin, Ireland.; Office of National Clinical Advisor, Integrated Care Programme for Prevention and Management of Chronic Disease, Dublin, Ireland.; Centric Health, Limerick, Ireland.; Department of Physical Education and Sports Science, University of Limerick, Limerick, Ireland.; Department of Endocrinology, Naas General Hospital, Kildare, and Tallaght University Hospital, Dublin, Ireland.

DOI: 10.1159/000527131

Link outs

Free resources

Full Text Sources:

Medical:

https://medlineplus.gov/obesity.html

Miscellaneous:

https://assays.cancer.gov/non-CPTAC-3993

MeSH Terms: Adult, Humans, Ireland, Canada, Obesity, Overweight, Weight Loss, Chronic Disease