[The problem of evidence-based guidelines using the example of the treatment of obesity]

Despite many therapeutic strategies used by experts and general practitioners, the obesity problem has still increased in the developed countries. Therefore it is necessary to provide evidence-based references for good clinical practice. The guideline presented in Cologne in 1997 was published in an improved form in 1998. However, the consequences and circumstances do not only promise benefit but lead to new questions: Where are the indications for implementation and the participation of the main users, the general practitioners? Why should the procedures of tests and consensus not used additionally? The co-morbidity, biography, genetics, and the number of relapses of patients are probably not emphasized enough, the use of drugs could be considered more carefully. Although the reviewed guideline is important, there is a lack in providing the information and in advice for procedures of co-operation in primary health care. The great therapeutic problem and understanding for the daily practice has not been estimated enough.