Obesity in adults: a clinical practice guideline

Sean Wharton1, David C W Lau2, Michael Vallis2

  • 1Departments of Medicine (Wharton), Endocrinology and Metabolism (Poddar, Sherifali), Family Medicine (Naji, Tytus) and Health Research Methods, Evidence and Impact Canada (Naji), McMaster University, Hamilton, Ont; The Wharton Medical Clinic (Wharton, Poddar), Hamilton, Ont.; Departments of Medicine (Lau, Nerenberg) and Family Medicine (Boyling, Henderson, McInnes, Walji, Wicklum), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Julia McFarlane Diabetes Research Centre and Libin Cardiovascular Institute of Alberta (Lau), Calgary, Alta.; Department of Family Medicine (Vallis, Piccinini-Vallis), Dalhousie University, Halifax, NS; Departments of Medicine (Sharma, Toth), Family Medicine (Campbell-Scherer, Kemp), Agricultural, Food and Nutritional Science (Bell, Pereira), Physical Education and Recreation (Boulé), and Occupational Therapy (Forhan), University of Alberta, Edmonton, Alta.; Adult Bariatric Specialty Clinic (Sharma), Royal Alexandra Hospital, Edmonton, Alta.; Obesity Canada (Sharma, Patton, Ramos Salas), Edmonton, Alta.; Department of Surgery (Biertho), Laval University, Quebec, Que.; School of Human Kinetics (Adamo, Prud'homme), University of Ottawa, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Alberga), Concordia University, Montréal, Que.; Bariatric Centre of Excellence (Brown), The Ottawa Hospital, Ottawa, Ont.; Departments of Family Practice (Calam) and Endocrinology (Manjoo), University of British Columbia, Vancouver, BC; UBC Family Practice Residency Program (Calam) and Pfizer/Heart and Stroke Foundation Chair in Cardiovascular Prevention Research (Lear), St. Paul's Hospital, Vancouver, BC; nutrition consultant (Clarke), Hamilton, Ont.; Indigenous Health Dialogue (Crowshoe), Health Sciences Centre, University of Calgary, Calgary, Alta.; Main East Medical Associates (Divalentino), Hamilton, Ont.; Bariatric Medical Institute (Freedhoff), Ottawa, Ont.; Department of Family Medicine (Freedhoff) and Division of Endocrinology and Metabolism (Shiau), Department of Medicine, University of Ottawa, Ottawa, Ont.; Herbert Wertheim School of Medicine (Gagner), Florida International University, Miami, Fla.; Hôpital du Sacre Coeur de Montréal (Gagner), Montréal, Que.; Humber River Hospital (Glazer), Toronto, Ont.; Division of Endocrinology and Metabolism (Glazer), Queen's University, Kingston, Ont.; Departments of Internal Medicine (Glazer), Psychiatry (Hawa, Sockalingam), Family and Community Medicine (Macklin) and Nutritional Sciences (Sievenpiper), University of Toronto, Toronto, Ont.; Alberta Health Services (Grand, Hung, Johnson-Stoklossa), Edmonton, Alta.; Departments of Family Medicine and Public Health Sciences and Policy Studies (Green), Queen's University, Kingston, Ont.; Kingston Health Sciences Centre (Green), Kingston, Ont.; Providence Care Hospital (Green), Kingston, Ont.; Centre for Addiction and Mental Health (Hahn, Sockalingam), Toronto, Ont.; University Health Network (Hawa, Sockalingam), Toronto, Ont.; Division of General Surgery (Hong), McMaster University, Hamilton, Ont.; Department of Family Medicine and Biobehavioral Health (Jacklin), University of Minnesota Medical School Duluth Campus, Duluth, Minn.; School of Kinesiology and Health Studies (Janssen), Queen's University, Kingston, Ont.; School of Health and Human Performance (Kirk), Dalhousie University, Halifax, NS; School of Kinesiology and Health Science (Wharton, Kuk), York University, Toronto, Ont.; Division of Endocrinology (Langlois), Université de Sherbrooke, Sherbrooke, Que.; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre hospitalier universitaire de Sherbrooke (Langlois), Sherbrooke, Que.; School of Kinesiology (Lear), Simon Fraser University, Vancouver, BC; Medcan Clinic (Macklin), Toronto, Ont.; Cardiometabolic Collaborative Clinic (Manjoo), Vancouver Island Health Authority, Victoria, BC; Institut universitaire de cardiologie et de pneumologie de Québec (Morin, Poirier), Laval University, Québec, Que.; Foothills Medical Centre (Nerenberg), Calgary, Alta.; C-ENDO Diabetes & Endocrinology Clinic (Pedersen), Calgary, Alta.; LMC Diabetes and Endocrinology ( Poddar), Toronto, Ont.; Department of Medicine (Rueda-Clausen), University of Saskatchewan, Regina, Sask.; Regina General Hospital (Rueda-Clausen), Regina, Sask.; Education Psychology (Russell-Mayhew), Werklund School of Education, University of Calgary, Calgary, Alta.; LEAF Weight Management Clinic (Shiau), Ottawa, Ont.; Heather M. Arthur Population Health Research Institute/Hamilton Health Sciences Chair in Interprofessional Health Research, School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Division of Endocrinology & Metabolism (Sievenpiper), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry (Taylor), University of Calgary, Calgary, Alta.; School of Pharmacy (Twells), Memorial University, St. John's, NL; Steelcity Medical Clinic (Tytus), Hamilton, Ont.; Calgary Weight Management Centre (Walji), Calgary, Alta.; School of Population and Public Health (Walker), University of British Columbia, Vancouver, BC; Centre for Excellence in Indigenous Health (Walker), University of British Columbia, Vancouver, BC.; O'Brien Institute of Public Health (Wicklum), University of Calgary, Calgary, Alta. sean.wharton@utoronto.ca.

Abstract

No abstract available in PubMed .

Related Concept Videos

Obesity01:24

Obesity

The Body Mass Index (BMI) is a numerical value derived from a person's weight and height, used to categorize individuals into weight ranges. It is calculated using the formula: weight in kilograms divided by height in meters squared. Obesity is a health condition characterized by excessive accumulation of adipose tissue that poses health risks, often diagnosed with a BMI ≥ 30. This excess fat storage occurs when surplus dietary calories are converted into triglycerides and stored in...
1.0K
Drug Dosing: Obese Patients01:21

Drug Dosing: Obese Patients

In the United States, obesity is a prominent concern. It is linked to heightened mortality rates due to increased occurrences of conditions such as hypertension, atherosclerosis, coronary artery disease, and diabetes compared to nonobese individuals. A patient is classified as obese if their actual body weight surpasses the ideal or desirable body weight by 20%, based on Metropolitan Life Insurance Company data. Ideal body weights consider average weights and heights for males and females...
141
Pharmacokinetics in Obese Patients: Drug Absorption and Distribution01:25

Pharmacokinetics in Obese Patients: Drug Absorption and Distribution

Obesity significantly alters the pharmacokinetic processes of drug absorption and distribution, presenting unique challenges in medical treatment. The increased fat tissue and decreased lean muscle in obese individuals can significantly affect how drugs are absorbed into the body and distributed across different tissues. This alteration can lead to variances in the effectiveness and safety of medications, necessitating adjustments in dosing or drug selection for obese patients.One notable...
144
Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion01:20

Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion

Drug metabolism, a critical process in the liver, involves two primary phases: Phase I reactions and Phase II conjugation. Obesity introduces significant alterations in this metabolic process, primarily due to fatty infiltration of the liver, leading to conditions such as nonalcoholic fatty liver disease (NAFLD). This condition can modify the activities of both Phase I and II enzymes, impacting how drugs are metabolized in obese patients.Phase I metabolism sees variable effects across...
99
Chronic Obstructive Pulmonary Disease-V: Management01:29

Chronic Obstructive Pulmonary Disease-V: Management

Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
2.9K
Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
766