Management of obesity: improvement of health-care training and systems for prevention and care

Dietz, William H.; Baur, Louise A.; Hall, Kevin D.; Puhl, Rebecca M.; Taveras, Elsie M.; Uauy, Ricardo; Kopelman, Peter

doi:10.1016/s0140-6736(14)61748-7

Cited by 349 publications

(322 citation statements)

References 95 publications

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“…[10][11][12][13] Dietz and colleagues warn that preventive strategies are unlikely to reduce weight in people living with severe obesity and stress the need for changes in the delivery of care for these patients. 14 In combination with previous research, this study highlights the current failures in combatting existing obesity cases at a population level.…”

Section: Summary Of Findingssupporting

confidence: 62%

Probability of an Obese Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records

et al. 2015

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Objectives: Obesity is an increasing clinical and public health concern. This study aimed to answer the question: 'What is the probability of an obese person attaining normal body weight?'Methods: A sample of men and women aged 20 years and over was drawn from the Clinical Practice Research Datalink (CPRD). Participants who received bariatric surgery were excluded. The probability of attaining either normal weight, or 5% reduction in body weight, were estimated. women attained normal body weight. In simple obesity (BMI 30·0-34·9 Kg/m 2 ), the annual probability of attaining normal weight was 1 in 210 for men and 1 in 124 for women, increasing to 1 in 1,290 for men and 1 in 677 for women with morbid obesity (BMI 40·0-44·9 Kg/m 2 ). The annual probability of achieving a 5% weight reduction was 1 in 8 for men, and 1 in 7 for women with morbid obesity. Among participants who lost 5% body weight, 52·7% (95% confidence interval 52·4 to 53·0%) showed weight regain at two years and 78·0% (77·7 to 78·3%) at five years. Conclusions:The low probability of attaining normal weight, or maintaining weight loss, raises questions concerning whether current obesity treatment frameworks, grounded in community-based weight management programmes, may be expected to achieve public health impact.3

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Section: Summary Of Findingssupporting

confidence: 62%

Probability of an Obese Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records

et al. 2015

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“…Although primary care could become an improved source for healthy weight surveillance, a whole system population health approach to prevention is necessary. 16,25,37 Our study shows the first steps toward improving our knowledge so that, collectively, clinical and community partners know how, when and where to focus and scale successful health promotion programming and policies.…”

Section: Resultsmentioning

confidence: 92%

“…In addition, the lack of objectively measured data at regional levels severely limits design and evaluation efforts of a "whole system" public health approach to the prevention of childhood obesity. 16 We conducted this study to determine the prevalence of overweight and obesity, using measured heights and weights for toddlers, children and adolescents aged less than 20 years, derived from a sample of primary care electronic medical records (EMRs) from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) chronic disease database. 17,18 In particular, to fill the known data gap, we examined height and weight data for toddlers less than 2 years of age and assessed them in relation to a known well-child visit, the enhanced 18-month well-baby visit.…”

mentioning

confidence: 99%

Prevalence of toddler, child and adolescent overweight and obesity derived from primary care electronic medical records: an observational study

Biro¹,

Barber

Williamson

et al. 2016

CMAJ Open

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“…Professional education about obesity management needs improvement, and promising innovations in weight management need to be examined. 88 The synergy between treatment and prevention means that weight loss is easiest in healthy environments and, conversely, prevention eff orts are greatly strengthened by strong advocacy from the medical profession.…”

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confidence: 99%

Strengthening of accountability systems to create healthy food environments and reduce global obesity

et al. 2015

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To achieve WHO's target to halt the rise in obesity and diabetes, dramatic actions are needed to improve the healthiness of food environments. Substantial debate surrounds who is responsible for delivering eff ective actions and what, specifi cally, these actions should entail. Arguments are often reduced to a debate between individual and collective responsibilities, and between hard regulatory or fi scal interventions and soft voluntary, education-based approaches. Genuine progress lies beyond the impasse of these entrenched dichotomies. We argue for a strengthening of accountability systems across all actors to substantially improve performance on obesity reduction. In view of the industry opposition and government reluctance to regulate for healthier food environments, quasiregulatory approaches might achieve progress. A four step accountability framework (take the account, share the account, hold to account, and respond to the account) is proposed. The framework identifi es multiple levers for change, including quasiregulatory and other approaches that involve government-specifi ed and government-monitored progress of private sector performance, government procurement mechanisms, improved transparency, monitoring of actions, and management of confl icts of interest. Strengthened accountability systems would support government leadership and stewardship, constrain the infl uence of private sector actors with major confl icts of interest on public policy development, and reinforce the engagement of civil society in creating demand for healthy food environments and in monitoring progress towards obesity action objectives.

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Management of obesity: improvement of health-care training and systems for prevention and care

Cited by 349 publications

References 95 publications

Probability of an Obese Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records

Probability of an Obese Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records

Prevalence of toddler, child and adolescent overweight and obesity derived from primary care electronic medical records: an observational study

Strengthening of accountability systems to create healthy food environments and reduce global obesity

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