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Review
. 2022 Sep-Oct;16(5):353-363.
doi: 10.1016/j.orcp.2022.08.003. Epub 2022 Aug 30.

The Australian Obesity Management Algorithm: A simple tool to guide the management of obesity in primary care

Tania P Markovic  1 , Joseph Proietto  2 , John B Dixon  3 , Georgia Rigas  4 , Gary Deed  5 , Jeffrey M Hamdorf  6 , Erica Bessell  7 , Nathalie Kizirian  8 , Sofianos Andrikopoulos  9 , Stephen Colagiuri  10
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Free article
Review

The Australian Obesity Management Algorithm: A simple tool to guide the management of obesity in primary care

Tania P Markovic et al. Obes Res Clin Pract. 2022 Sep-Oct.
Free article

Abstract

Obesity is a complex and multifactorial chronic disease with genetic, environmental, physiological and behavioural determinants that requires long-term care. Obesity is associated with a broad range of complications including type 2 diabetes, cardiovascular disease, dyslipidaemia, metabolic associated fatty liver disease, reproductive hormonal abnormalities, sleep apnoea, depression, osteoarthritis and certain cancers. An algorithm has been developed (with PubMed and Medline searched for all relevant articles from 1 Jan 2000-1 Oct 2021) to (i) assist primary care physicians in treatment decisions for non-pregnant adults with obesity, and (ii) provide a practical clinical tool to guide the implementation of existing guidelines (summarised in Appendix 1) for the treatment of obesity in the Australian primary care setting. MAIN RECOMMENDATIONS AND CHANGES IN MANAGEMENT: Treatment pathways should be determined by a person's anthropometry (body mass index (BMI) and waist circumference (WC)) and the presence and severity of obesity-related complications. A target of 10-15% weight loss is recommended for people with BMI 30-40 kg/m2 or abdominal obesity (WC > 88 cm in females, WC > 102 cm in males) without complications. The treatment focus should be supervised lifestyle interventions that may include a reduced or low energy diet, very low energy diet (VLED) or pharmacotherapy. For people with BMI 30-40 kg/m2 or abdominal obesity and complications, or those with BMI > 40 kg/m2 a weight loss target of 10-15% body weight is recommended, and management should include intensive interventions such as VLED, pharmacotherapy or bariatric surgery, which may be required in combination. A weight loss target of > 15% is recommended for those with BMI > 40 kg/m2 and complications and they should be referred to specialist care. Their treatment should include a VLED with or without pharmacotherapy and bariatric surgery.

Keywords: Anti-obesity pharmacotherapy; Bariatric surgery; Low energy diet; Obesity; Physical activity; Reduced energy diet; Very low energy diet.

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Conflict of interest statement

Competing interest statement TPM has received support from Novo Nordisk for seminar presentations at conferences and Eli Lilly for participation in an advisory board. She serves on the Nestle Health Science VLCD Advisory Board. JP is on Advisory Boards for Novo Nordisk and iNOVA and has given lectures on obesity management for Novo Nordisk and iNova. JBD has received support from I-Nova as a consultant, advisory board and speaker fees; Nestle Health Science Consultant, advisory board and speaker fees; Novo Nordisk: Advisory board and speaker fees. GR has received consulting and speaking honoraria from NovoNordisk, iNova, Ethicon (Johnson & Johnson), Reshape HelathSciences and Nestle HealthScience. GD has received payments from Novo Nordisk, Inova pharmaceuticals for participation in advisory boards and seminar presentations at conferences. SC has received payments from Novo Nordisk and iNOVA pharmaceuticals for participation in advisory boards.

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