Management of obesity: summary of SIGN guideline

In Scotland 68.5% of men, 61.8% of women, 36.1% of boys, and 26.9% of girls are classified as overweight or obese.1 The cost of obesity and obesity related illnesses to the NHS in Scotland was estimated to be £171m (€190m; $273m) in 2001,2 and forecasts in England suggest that NHS expenditure attributable to these conditions could double between 2007 and 2050.3 Being obese at age 40 reduces life expectancy by 7.1 years for women and 5.8 years for men.4 Given the massive detrimental effect of obesity on health and wellbeing, all health professionals should know how obesity should be managed. This article summarises the most recent recommendations from the Scottish Intercollegiate Guidelines Network (SIGN) on the management of obesity.5 SIGN recommendations are based on systematic reviews of best available evidence, and the strength of the evidence is indicated as A, B, C, or D (figure⇓). Recommended best practice (“good practice points”), based on the clinical experience of the guideline development group, is also indicated (as GPP). Explanation of SIGN grades of recommendations ### Classification Use body mass index (BMI) to classify overweight or obesity in adults (B): Waist circumference may be used in addition to BMI to help assess the risk of obesity related comorbidities (C). Waist circumference cut-off values for an increased risk of obesity related health problems are: ### Prevention and identification of high risk groups