The Saudi clinical practice guideline for the management of overweight and obesity in adults
Assim A. AlfaddaObesity Research Center,College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail. [email protected]Madhawi AldhwayanFrom the Obesity Research Center (Alfadda, Al-Dhwayan, Sallam), Department of Medicine (Alfadda), Clinical Chemistry Unit, Pathology Department (Sallam), College of Medicine, Department of Community Health Sciences (Al-Dhwayan), College of Applied Medical Sciences, King Saud University, Post Graduate Program in Family Medicine (Al Khudhair), Ministry of Health, the Obesity, Endocrine, and Metabolism Center (Alzahrani), King Fahad Medical City Riyadh, Preventive Medicine Department (Alharbi), Ministry of Health, Yanbu General Hospital, Yanbu, Department of Medicine (Al Nozha), Taibah University, Madinah, the Family Medicine Post Graduate Centre (Al-Qahtani), Ministry of Health, Khobar, Directorate of Health Affairs, and the Directorate of Public Health (Bardisi), Prince Abdul Majeed Health Center, Kingdom of Saudi Arabia, Department of Family Medicine (Riva, Moore), and the Department of Clinical Epidemiology & Biostatistics and Medicine (Brożek, Schünemann), McMaster University, Hamilton, CanadaAbdulhameed A. AlharbiFrom the Obesity Research Center (Alfadda, Al-Dhwayan, Sallam), Department of Medicine (Alfadda), Clinical Chemistry Unit, Pathology Department (Sallam), College of Medicine, Department of Community Health Sciences (Al-Dhwayan), College of Applied Medical Sciences, King Saud University, Post Graduate Program in Family Medicine (Al Khudhair), Ministry of Health, the Obesity, Endocrine, and Metabolism Center (Alzahrani), King Fahad Medical City Riyadh, Preventive Medicine Department (Alharbi), Ministry of Health, Yanbu General Hospital, Yanbu, Department of Medicine (Al Nozha), Taibah University, Madinah, the Family Medicine Post Graduate Centre (Al-Qahtani), Ministry of Health, Khobar, Directorate of Health Affairs, and the Directorate of Public Health (Bardisi), Prince Abdul Majeed Health Center, Kingdom of Saudi Arabia, Department of Family Medicine (Riva, Moore), and the Department of Clinical Epidemiology & Biostatistics and Medicine (Brożek, Schünemann), McMaster University, Hamilton, CanadaBasema K. Al KhudhairFrom the Obesity Research Center (Alfadda, Al-Dhwayan, Sallam), Department of Medicine (Alfadda), Clinical Chemistry Unit, Pathology Department (Sallam), College of Medicine, Department of Community Health Sciences (Al-Dhwayan), College of Applied Medical Sciences, King Saud University, Post Graduate Program in Family Medicine (Al Khudhair), Ministry of Health, the Obesity, Endocrine, and Metabolism Center (Alzahrani), King Fahad Medical City Riyadh, Preventive Medicine Department (Alharbi), Ministry of Health, Yanbu General Hospital, Yanbu, Department of Medicine (Al Nozha), Taibah University, Madinah, the Family Medicine Post Graduate Centre (Al-Qahtani), Ministry of Health, Khobar, Directorate of Health Affairs, and the Directorate of Public Health (Bardisi), Prince Abdul Majeed Health Center, Kingdom of Saudi Arabia, Department of Family Medicine (Riva, Moore), and the Department of Clinical Epidemiology & Biostatistics and Medicine (Brożek, Schünemann), McMaster University, Hamilton, CanadaOmar M. Al NozhaFrom the Obesity Research Center (Alfadda, Al-Dhwayan, Sallam), Department of Medicine (Alfadda), Clinical Chemistry Unit, Pathology Department (Sallam), College of Medicine, Department of Community Health Sciences (Al-Dhwayan), College of Applied Medical Sciences, King Saud University, Post Graduate Program in Family Medicine (Al Khudhair), Ministry of Health, the Obesity, Endocrine, and Metabolism Center (Alzahrani), King Fahad Medical City Riyadh, Preventive Medicine Department (Alharbi), Ministry of Health, Yanbu General Hospital, Yanbu, Department of Medicine (Al Nozha), Taibah University, Madinah, the Family Medicine Post Graduate Centre (Al-Qahtani), Ministry of Health, Khobar, Directorate of Health Affairs, and the Directorate of Public Health (Bardisi), Prince Abdul Majeed Health Center, Kingdom of Saudi Arabia, Department of Family Medicine (Riva, Moore), and the Department of Clinical Epidemiology & Biostatistics and Medicine (Brożek, Schünemann), McMaster University, Hamilton, CanadaNawal M. Al-QahtaniFrom the Obesity Research Center (Alfadda, Al-Dhwayan, Sallam), Department of Medicine (Alfadda), Clinical Chemistry Unit, Pathology Department (Sallam), College of Medicine, Department of Community Health Sciences (Al-Dhwayan), College of Applied Medical Sciences, King Saud University, Post Graduate Program in Family Medicine (Al Khudhair), Ministry of Health, the Obesity, Endocrine, and Metabolism Center (Alzahrani), King Fahad Medical City Riyadh, Preventive Medicine Department (Alharbi), Ministry of Health, Yanbu General Hospital, Yanbu, Department of Medicine (Al Nozha), Taibah University, Madinah, the Family Medicine Post Graduate Centre (Al-Qahtani), Ministry of Health, Khobar, Directorate of Health Affairs, and the Directorate of Public Health (Bardisi), Prince Abdul Majeed Health Center, Kingdom of Saudi Arabia, Department of Family Medicine (Riva, Moore), and the Department of Clinical Epidemiology & Biostatistics and Medicine (Brożek, Schünemann), McMaster University, Hamilton, CanadaSaad AlzahraniFrom the Obesity Research Center (Alfadda, Al-Dhwayan, Sallam), Department of Medicine (Alfadda), Clinical Chemistry Unit, Pathology Department (Sallam), College of Medicine, Department of Community Health Sciences (Al-Dhwayan), College of Applied Medical Sciences, King Saud University, Post Graduate Program in Family Medicine (Al Khudhair), Ministry of Health, the Obesity, Endocrine, and Metabolism Center (Alzahrani), King Fahad Medical City Riyadh, Preventive Medicine Department (Alharbi), Ministry of Health, Yanbu General Hospital, Yanbu, Department of Medicine (Al Nozha), Taibah University, Madinah, the Family Medicine Post Graduate Centre (Al-Qahtani), Ministry of Health, Khobar, Directorate of Health Affairs, and the Directorate of Public Health (Bardisi), Prince Abdul Majeed Health Center, Kingdom of Saudi Arabia, Department of Family Medicine (Riva, Moore), and the Department of Clinical Epidemiology & Biostatistics and Medicine (Brożek, Schünemann), McMaster University, Hamilton, CanadaWedad BardisiFrom the Obesity Research Center (Alfadda, Al-Dhwayan, Sallam), Department of Medicine (Alfadda), Clinical Chemistry Unit, Pathology Department (Sallam), College of Medicine, Department of Community Health Sciences (Al-Dhwayan), College of Applied Medical Sciences, King Saud University, Post Graduate Program in Family Medicine (Al Khudhair), Ministry of Health, the Obesity, Endocrine, and Metabolism Center (Alzahrani), King Fahad Medical City Riyadh, Preventive Medicine Department (Alharbi), Ministry of Health, Yanbu General Hospital, Yanbu, Department of Medicine (Al Nozha), Taibah University, Madinah, the Family Medicine Post Graduate Centre (Al-Qahtani), Ministry of Health, Khobar, Directorate of Health Affairs, and the Directorate of Public Health (Bardisi), Prince Abdul Majeed Health Center, Kingdom of Saudi Arabia, Department of Family Medicine (Riva, Moore), and the Department of Clinical Epidemiology & Biostatistics and Medicine (Brożek, Schünemann), McMaster University, Hamilton, CanadaReem M. SallamFrom the Obesity Research Center (Alfadda, Al-Dhwayan, Sallam), Department of Medicine (Alfadda), Clinical Chemistry Unit, Pathology Department (Sallam), College of Medicine, Department of Community Health Sciences (Al-Dhwayan), College of Applied Medical Sciences, King Saud University, Post Graduate Program in Family Medicine (Al Khudhair), Ministry of Health, the Obesity, Endocrine, and Metabolism Center (Alzahrani), King Fahad Medical City Riyadh, Preventive Medicine Department (Alharbi), Ministry of Health, Yanbu General Hospital, Yanbu, Department of Medicine (Al Nozha), Taibah University, Madinah, the Family Medicine Post Graduate Centre (Al-Qahtani), Ministry of Health, Khobar, Directorate of Health Affairs, and the Directorate of Public Health (Bardisi), Prince Abdul Majeed Health Center, Kingdom of Saudi Arabia, Department of Family Medicine (Riva, Moore), and the Department of Clinical Epidemiology & Biostatistics and Medicine (Brożek, Schünemann), McMaster University, Hamilton, CanadaJohn J. RivaFrom the Obesity Research Center (Alfadda, Al-Dhwayan, Sallam), Department of Medicine (Alfadda), Clinical Chemistry Unit, Pathology Department (Sallam), College of Medicine, Department of Community Health Sciences (Al-Dhwayan), College of Applied Medical Sciences, King Saud University, Post Graduate Program in Family Medicine (Al Khudhair), Ministry of Health, the Obesity, Endocrine, and Metabolism Center (Alzahrani), King Fahad Medical City Riyadh, Preventive Medicine Department (Alharbi), Ministry of Health, Yanbu General Hospital, Yanbu, Department of Medicine (Al Nozha), Taibah University, Madinah, the Family Medicine Post Graduate Centre (Al-Qahtani), Ministry of Health, Khobar, Directorate of Health Affairs, and the Directorate of Public Health (Bardisi), Prince Abdul Majeed Health Center, Kingdom of Saudi Arabia, Department of Family Medicine (Riva, Moore), and the Department of Clinical Epidemiology & Biostatistics and Medicine (Brożek, Schünemann), McMaster University, Hamilton, CanadaJan BrożekFrom the Obesity Research Center (Alfadda, Al-Dhwayan, Sallam), Department of Medicine (Alfadda), Clinical Chemistry Unit, Pathology Department (Sallam), College of Medicine, Department of Community Health Sciences (Al-Dhwayan), College of Applied Medical Sciences, King Saud University, Post Graduate Program in Family Medicine (Al Khudhair), Ministry of Health, the Obesity, Endocrine, and Metabolism Center (Alzahrani), King Fahad Medical City Riyadh, Preventive Medicine Department (Alharbi), Ministry of Health, Yanbu General Hospital, Yanbu, Department of Medicine (Al Nozha), Taibah University, Madinah, the Family Medicine Post Graduate Centre (Al-Qahtani), Ministry of Health, Khobar, Directorate of Health Affairs, and the Directorate of Public Health (Bardisi), Prince Abdul Majeed Health Center, Kingdom of Saudi Arabia, Department of Family Medicine (Riva, Moore), and the Department of Clinical Epidemiology & Biostatistics and Medicine (Brożek, Schünemann), McMaster University, Hamilton, CanadaHolger J. SchünemannFrom the Obesity Research Center (Alfadda, Al-Dhwayan, Sallam), Department of Medicine (Alfadda), Clinical Chemistry Unit, Pathology Department (Sallam), College of Medicine, Department of Community Health Sciences (Al-Dhwayan), College of Applied Medical Sciences, King Saud University, Post Graduate Program in Family Medicine (Al Khudhair), Ministry of Health, the Obesity, Endocrine, and Metabolism Center (Alzahrani), King Fahad Medical City Riyadh, Preventive Medicine Department (Alharbi), Ministry of Health, Yanbu General Hospital, Yanbu, Department of Medicine (Al Nozha), Taibah University, Madinah, the Family Medicine Post Graduate Centre (Al-Qahtani), Ministry of Health, Khobar, Directorate of Health Affairs, and the Directorate of Public Health (Bardisi), Prince Abdul Majeed Health Center, Kingdom of Saudi Arabia, Department of Family Medicine (Riva, Moore), and the Department of Clinical Epidemiology & Biostatistics and Medicine (Brożek, Schünemann), McMaster University, Hamilton, CanadaAinsley MooreFrom the Obesity Research Center (Alfadda, Al-Dhwayan, Sallam), Department of Medicine (Alfadda), Clinical Chemistry Unit, Pathology Department (Sallam), College of Medicine, Department of Community Health Sciences (Al-Dhwayan), College of Applied Medical Sciences, King Saud University, Post Graduate Program in Family Medicine (Al Khudhair), Ministry of Health, the Obesity, Endocrine, and Metabolism Center (Alzahrani), King Fahad Medical City Riyadh, Preventive Medicine Department (Alharbi), Ministry of Health, Yanbu General Hospital, Yanbu, Department of Medicine (Al Nozha), Taibah University, Madinah, the Family Medicine Post Graduate Centre (Al-Qahtani), Ministry of Health, Khobar, Directorate of Health Affairs, and the Directorate of Public Health (Bardisi), Prince Abdul Majeed Health Center, Kingdom of Saudi Arabia, Department of Family Medicine (Riva, Moore), and the Department of Clinical Epidemiology & Biostatistics and Medicine (Brożek, Schünemann), McMaster University, Hamilton, Canada
2016en
ABI
Annotatsiya
OBJECTIVE: To assist healthcare providers in evidence-based clinical decision-making for the management of overweight and obese adults in Saudi Arabia. METHODS: The Ministry of Health, Riyadh, Kingdom of Saudi Arabia assembled an expert Saudi panel to produce this clinical practice guideline in 2015. In collaboration with the methodological working group from McMaster University, Hamilton, Canada, using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, which describes both the strength of recommendation and the quality of evidence RESULTS: After identifying 11 questions, corresponding recommendations were agreed upon as guidance for the management of overweight and obese adults. These included strong recommendations in support of lifestyle interventions rather than usual care alone, individualized counseling interventions rather than generic educational pamphlets, physical activity rather than no physical activity, and physical activity in addition to diet rather than diet alone. Metformin and orlistat were suggested as conditional recommendations for the management of overweight and obesity in adults. Bariatric surgery was recommended, conditionally, for the management of obese adults (body mass index of ≥40 or ≥35 kg/m2 with comorbidities). CONCLUSIONS: The current guideline includes recommendation for the non-pharmacological, pharmacological, and surgical management of overweight and obese adults. In addition, the panel recommends conducting research priorities regarding lifestyle interventions and economic analysis of drug therapy within the Saudi context, as well as long term benefits and harms of bariatric surgery.
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