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

journal contribution
posted on 2023-02-20, 05:26 authored by C Breen, J O'connell, J Geoghegan, D O'shea, S Birney, L Tully, K Gaynor, M O'kelly, G O'malley, C O'donovan, O Lyons, M Flynn, S Allen, N Arthurs, S Browne, C O'grada, E O'malley, O O'reilly, Sharleen O'ReillySharleen O'Reilly, O Porter, HM Roche, A Rhynehart, L Ryan, S Seery, C Soare, F Shaamile, A Walsh, C Woods, R Yoder
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.