Health and diet are big topics in Australia, with about 60% of adult Australians overweight or obese. To help provide the evidence needed to fight obesity, NHMRC has increased its funding for obesity research and issued updated Australian Dietary Guidelines to help Australians make better decisions about the food they eat.
To improve health outcomes for overweight and obese adults, adolescents and children, newly released clinical practice guidelines will assist clinicians to start those personal discussions with patients who may benefit from weight loss.
Clinicians are increasingly being asked to give advice to patients about their weight as part of health consultations. There is a critical demand for credible, evidence-based guidance on weight management and nutrition.
“Support from primary healthcare providers through tailored weight management programs can make this personal challenge achievable”, NHMRC CEO Professor Anderson said.
Intended for use by general practitioners, general practice nurses, primary care health professionals and allied health professionals, the guidelines follow the primary care ‘5As’ framework: ask and assess, advise, assist, arrange.
The ‘ask and assess’ approach aims to identify people who will benefit from help including any factors that are contributing to their excess weight. Providers will then use the guidelines to ‘advise’ individuals before ‘assisting’ the individual to develop a tailored weight loss program.
The ‘arrange’ approach assists the individual through referrals, follow up visits and other support to lose weight and keep it off. If one approach isn’t successful, the guidelines support a review and revision of the plan.
Specific advice is also provided for the management of overweight and obesity in children. The most significant benefit of weight management in childhood and adolescence is in preventing overweight or obesity in adulthood.
“The evidence underpinning this new guideline tells us that a 5% initial weight loss can reduce the risk of health problems like diabetes and cardiovascular disease,” Professor Anderson said.
The obesity guidelines complement the Australian Dietary Guidelines and Eat for Health resources launched in February, which provide information based on the best available scientific evidence. They have been developed to help Australians choose foods that promote their health and wellbeing while reducing their risk of chronic disease.
NHMRC also provides significant funding for research into obesity, and this has been growing at a rapid rate. In 2012, NHMRC provided $38.5 million for obesity research, compared to $18.3 million five years earlier (2007). Over the last 10 years, NHMRC has provided a total of $216.4 million for obesity research. Currently NHMRC supports two Centres of Research Excellence focused on obesity, nutritional science and health.
Key messages for clinicians treating adults
- Measure waist circumference in addition to calculating BMI.
- Discuss readiness to change lifestyle behaviours.
- Convey the message that even small amounts of weight loss improve health and wellbeing.
- Refer appropriately to assist people to make lifestyle changes or for further intervention.
- Use multidisciplinary approaches - these work better than single interventions.
- Support a self-management approach and provide ongoing monitoring.
Key messages for clinicians treating children and adolescents
Use BMI charts to monitor growth.
Promote physical activity, dietary modification and healthy behaviours to families.
Aim for weight maintenance rather than weight loss.
Refer for further assessment and specialist assistance with lifestyle interventions if warranted.
Encourage reduced screen time.
Relationship to the Australian Dietary Guidelines
- The companion Australian Dietary Guidelines (and the Eat for Health resources) focus on what Australians should eat to be healthy and prevent diet related diseases.
- The Obesity Guidelines focus on what interventions are effective for weight loss, and how this can best be managed in a clinical context.
- The Obesity and Dietary Guidelines both recommend healthy eating, physical activity and behavioural modification to address overweight and obesity.
- Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, Adolescents and Children (2013)
- Eat for Health resources
David Cooper, 0422 008 512