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Obesity Surgery
Published in: Obesity Surgery 3/2016

01-03-2016 | Review Article

NICE-Accredited Commissioning Guidance for Weight Assessment and Management Clinics: a Model for a Specialist Multidisciplinary Team Approach for People with Severe Obesity

Authors: Richard Welbourn, John Dixon, Julian H. Barth, Nicholas Finer, Carly A. Hughes, Carel W. le Roux, John Wass, on behalf of the Guidance Development Group

Published in: Obesity Surgery | Issue 3/2016

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Abstract

Despite increasing prevalence of obesity, no country has successfully implemented comprehensive pathways to provide advice to all the severely obese patients that seek treatment. We aimed to formulate pathways for referral into and out of weight assessment and management clinics (WAMCs) that include internal medicine/primary care physicians as part of a multidisciplinary team that could provide specialist advice and interventions, including referral for bariatric surgery. Using a National Institute of Health and Care Excellence (NICE)-accredited process, a Guidance Development Group conducted a literature search identifying existing WAMCs. As very few examples of effective structures and clinical pathways existed, the current evidence base for optimal assessment and management of bariatric surgery patients was used to reach a consensus. The model we describe could be adopted internationally by health services to manage severely obese patients.
Literature
1.
Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:766–81.PubMedCentralCrossRefPubMed
2.
Atkinson RL. Current status of the field of obesity. Trends Endocrinol Metab: TEM. 2014;25:283–4.CrossRefPubMed
3.
4.
5.
6.
Bardia A, Holtan SG, Slezak JM, et al. Diagnosis of obesity by primary care physicians and impact on obesity management. Mayo Clin Proc. 2007;82:927–32.CrossRefPubMed
7.
8.
Bodenheimer T, Wagner E, Grumbach K. Improving primary care for patients with chronic illness: the chronic care model. JAMA. 2002;288:1775–9.CrossRefPubMed
9.
Hainer V. How should the obese patient be managed? Possible approaches to a national obesity management network. Int J Obes. 1999;23:S14–9.CrossRef
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
Morrison DS, Boyle S, Morrison S, et al. Evaluation of the first phase of a specialist weight management programme in the UK National Health Service: prospective cohort study. Public Health Nutr. 2012;15:22–38.CrossRef
22.
Lean M, Brosnahan N, McLoone P, et al. Feasibility and indicative results from a 12-month low-energy liquid diet treatment and maintenance programme for severe obesity. Br J Gen Pract. 2013;63:e115–24.PubMedCentralCrossRefPubMed
23.
24.
25.
Concato J, Shah N, Horwitz RI. Randomized, controlled trials, observational studies, and the hierarchy of research designs. N Engl J Med. 2000;342(25):1887–92.PubMedCentralCrossRefPubMed
26.
Benson K, Hartz AJ. A comparison of observational studies and randomized, controlled trials. N Engl J Med. 2000;342(25):1878–86.CrossRefPubMed
27.
28.
29.
Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: co-sponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity. 2013;21:S1–27 (2008 Clinical practice guidelines).PubMedCentralCrossRefPubMed
30.
Padwal RJ, Pajewski NM, Allison DB, et al. Using the Edmonton obesity staging system to predict mortality in a population-representative cohort of people. CMAJ. 2011;83:1–8.
31.
32.
Rollnick S, Heather N, Bell A. Negotiating behaviour change in medical settings: the development of brief motivational interviewing. J Ment Health. 1992;1:25–37.CrossRef
33.
Wadden TA, Sarwer DB. Behavioral assessment of candidates for bariatric surgery: a patient-oriented approach. Obesity. 2006;14:53S–62.CrossRefPubMed
34.
Dixon JB, Zimmet P, Alberti KG, Rubino F, on behalf of the International Diabetes Federation Taskforce on Epidemiology and Prevention. Bariatric surgery: an IDF statement for obese type 2 diabetes. Diabet Med. 2011;28:628–42.PubMedCentralCrossRefPubMed
35.
36.
Collazo-Clavell ML, Clark MM, McAlpine DE, et al. Assessment and preparation of patients for bariatric surgery. Mayo Clin Proc. 2006;81:S11–7.CrossRefPubMed
37.
38.
39.
40.
41.
Johnson JL, Slentz CA, Houmard JA, et al. Exercise training amount and intensity effects on metabolic syndrome (from studies of a targeted risk reduction intervention through defined exercise). Am J Cardiol. 2007;100(12):1759–66.PubMedCentralCrossRefPubMed
42.
43.
44.
45.
46.
Eypasch E, Williams JI, Wood-Dauphinee S, et al. Gastrointestinal Quality of Life Index: development, validation and application of a new instrument. Br J Surg. 1995;82:216–22.CrossRefPubMed
47.
48.
Fairburn CG, Beglin SJ. Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord. 1994;16:363–70.PubMed
49.
50.
51.
Stevens T, Spavin S, Scholtz S, et al. Your patient and weight-loss surgery. Adv Psychiatr Treat. 2012;18:418–25.CrossRef
52.
53.
Zijlstra H, Larsen JK, de Ridder DTD, et al. Initiation and maintenance of weight loss after laparoscopic adjustable gastric banding. the role of outcome expectation and satisfaction with the psychosocial outcome. Obes Surg. 2009;19:725–1.CrossRefPubMed
54.
Gibbons LM, Sarwer DB, Crerand CE, et al. Previous weight loss experiences of bariatric surgery candidates: how much have patients dieted prior to surgery? Obesity. 2006;14:70S–6.CrossRefPubMed
55.
Ochner CN, Dambkowski CL, Yeomans BL, et al. Pre-bariatric surgery weight loss requirements and the effect of preoperative weight loss on postoperative outcome. Int J Obes. 2012;36:1380–7.CrossRef
56.
57.
Cassie S, Menezes C, Birch DW, et al. Effect of preoperative weight loss in bariatric surgical patients: a systematic review. Surg Obes Relat Dis. 2011;7:760–7.CrossRefPubMed
58.
Livhits M, Mercado C, Yermilov I, et al. Does weight loss immediately before bariatric surgery improve outcomes: a systematic review. Surg Obes Relat Dis. 2009;5:713–21.CrossRefPubMed
59.
60.
Myers K, Hajek P, Hinds C, et al. Stopping smoking shortly before surgery and postoperative complications. A systematic review and meta-analysis. Ann Intern Med. 2011;171:983–9.
61.
Richman RM, Webster P, Salgo AR, et al. A shared care approach in obesity management: the general practitioner and a hospital based service. Int J Obes Relat Metab Disord. 1996;20:413–9.PubMed
62.
63.
Sjöström L, Lindroos A-K, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–93.CrossRefPubMed
64.
65.
66.
67.
Parretti HM, Hughes CA, O’Kane M, et al. Ten top tips for the management of patients post-bariatric surgery in primary care. Br J Obes. 2015;1:68–73.
68.
Metadata
Title
NICE-Accredited Commissioning Guidance for Weight Assessment and Management Clinics: a Model for a Specialist Multidisciplinary Team Approach for People with Severe Obesity
Authors
Richard Welbourn
John Dixon
Julian H. Barth
Nicholas Finer
Carly A. Hughes
Carel W. le Roux
John Wass
on behalf of the Guidance Development Group
Publication date
01-03-2016
Publisher
Springer US
Published in
Obesity Surgery / Issue 3/2016
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-015-2041-8

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