Effectiveness and Value of Treatment Options for Obesity—A Report for the California Technology Assessment Forum

Ollendorf, Daniel A.; Cameron, Christopher G.; Pearson, Steven D.

doi:10.1001/jamainternmed.2015.7189

Cited by 7 publications

(4 citation statements)

References 3 publications

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“…The search identified 2,560 references from the six electronic databases, of which 50 are included in the final report (Fig. ) . The GDG added 54 new references not included in the search .…”

Section: Resultsmentioning

confidence: 99%

Commissioning guidance for weight assessment and management in adults and children with severe complex obesity

et al. 2017

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SummaryThe challenge of managing the epidemic of patients with severe and complex obesity disease in secondary care is largely unmet. In England, the National Institute of Health and Care Excellence and the National Health Service England have published guidance on the provision of specialist (non-surgical) weight management services. We have undertaken a systematic review of 'what evidence exists for what should happen in/commissioning of: primary or secondary care weight assessment and management clinics in patients needing specialist care for severe and complex obesity?' using an accredited methodology to produce a model for organization of multidisciplinary team clinics that could be developed in every healthcare system, as an update to a previous review. Additions to the previous guidance were multidisciplinary team pathways for children/adolescent patients and their transition to adult care, anaesthetic assessment and recommendations for ongoing shared care with general practitioners, as a chronic disease management pathway.

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Section: Resultsmentioning

confidence: 99%

Commissioning guidance for weight assessment and management in adults and children with severe complex obesity

et al. 2017

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“…However, those who did not respond would be detectable early in the course of treatment, e.g., by 12 weeks, and such patients should discontinue the medication, be re-evaluated, and be considered for another medication or alternative or enhanced treatment modalities. 1,[10][11][12] Key question #3 was addressed, in part, using the findings from clinical trials, systematic reviews and metaanalyses. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] At 12 months after initiation of treatment, adjunct pharmacotherapy resulted in moderate additional weight loss compared to behavioral and lifestyle interventions alone, with a significantly greater proportion of patients losing 5 or 10% of total body weight.…”

Section: Hsrandd State Of the Art Conference On Weight Managementmentioning

confidence: 99%

“…Pharmacotherapy is recommended as an adjunct to behavior and lifestyle interventions. 1,[10][11][12] None of the WMM are on the VA National Formulary (VANF). All drugs are available through the non-formulary drug request process (i.e., prior authorization), provided that the veteran meets the requested drug's criteria for use (CFU).…”

mentioning

confidence: 99%

Pharmacotherapy for Weight Management in the VHA

et al. 2017

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Weight management medications (WMM) are underutilized as an adjunct to behavioral and lifestyle interventions. In fiscal years 2014-2015, a total of approximately 2500 veterans-a mere 2% of veterans receiving care from the Veterans Health Administration (VHA)-eligible for a WMM received a prescription for one. A State of the Art Conference on Weight Management workgroup, focused on pharmacotherapy, developed evidence-based recommendations and strategies to foster the appropriate use of WMM in the VHA. The workgroup identified patient, prescriber, and health system barriers to and facilitators for prescribing WMM. Barriers included patient and provider concerns about medication safety and efficacy, limited involvement of primary care, restrictive medication criteria for use (CFU), and skepticism among providers regarding the safety and efficacy of WMM and the perception of obesity as a disease. Potential facilitators for removing barriers included patient and provider education about WMM and the health benefits of weight loss, increased engagement of primary care providers in weight management, relaxation of the CFU, and creation of a system to help patients navigate through weight management treatment options. Several research questions were framed with regard to WMM in general, and specifically to the care of obese veterans. While some of the workgroup's conclusions reflect issues specific to the VHA, many are likely to be applicable to other health organizations.

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“…Increasing EOSS severity has been shown to correlate with mortality better than BMI [ 5 , 9 , 13 ], and has been linked to increased health service use, polypharmacy and less weight loss [ 6 , 13 ]. A previous technology assessment by the Institute for Clinical and Economic Review in 2015 recommended that health systems should use obesity classification systems, such as EOSS instead of BMI, to more effectively target treatment resources [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Use of the Edmonton Obesity Staging System for the Assessment of Weight Management Outcomes in People with Class 3 Obesity

et al. 2022

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We aimed to assess weight loss and metabolic outcomes by severity of weight-related complications following an intensive non-surgical weight management program (WMP) in an Australian public hospital. A retrospective cohort study of all patients aged ≥18 years with body mass index (BMI) ≥ 40 enrolled in the WMP during March 2018–March 2019 with 12-month follow-up information were stratified using the Edmonton Obesity Staging System (EOSS). Of 178 patients enrolled in the WMP, 112 (62.9%) completed at least 12 months’ treatment. Most patients (96.6%) met EOSS-2 (56.7%) or EOSS-3 (39.9%) criteria for analysis. Both groups lost significant weight from baseline to 12 months; EOSS-2: 139.4 ± 31.8 kg vs. 131.8 ± 31.8 kg (p < 0.001) and EOSS-3: 141.4 ± 24.2 kg vs. 129.8 ± 24.3 kg (p < 0.001). After adjusting for baseline age, sex and employment status, mean weight loss was similar but a greater proportion of EOSS-3 achieved >10% weight loss compared to EOSS-2, (40% vs. 15.9%, p = 0.024). Changes in metabolic parameters including HbA1c, BP and lipids did not differ between EOSS-2 and 3. Despite increased clinical severity, adult patients with class 3 obesity achieved clinically meaningful weight loss and similar improvements in metabolic parameters compared to patients with less severe complications after 12 months in an intensive non-surgical WMP.

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Effectiveness and Value of Treatment Options for Obesity—A Report for the California Technology Assessment Forum

Cited by 7 publications

References 3 publications

Commissioning guidance for weight assessment and management in adults and children with severe complex obesity

Commissioning guidance for weight assessment and management in adults and children with severe complex obesity

Pharmacotherapy for Weight Management in the VHA

Clinical Use of the Edmonton Obesity Staging System for the Assessment of Weight Management Outcomes in People with Class 3 Obesity

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