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Published on 8 de noviembre de 2022 | http://doi.org/10.5867/medwave.2022.10.2649
Obesity in adults: Clinical practice guideline adapted for Chile
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Summary of the de novo recommendations and the adapted recommendation.
| Recommendation 1 | The CCEO suggests using liraglutide 3.0 mg as a pharmacologic intervention compared to not using liraglutide use for body weight reduction in treating adults living with overweight or obesity. |
| Strength of evidence: moderate | |
| Strength of recommendation: conditional | |
| Recommendation 1 | The CCEO suggests using phentermine as a pharmacologic intervention for body weight reduction in adult patients living with overweight or obesity. |
| Strength of evidence: low | |
| Strength of recommendation: conditional | |
| Recommendation 2 | The CCEO suggests that students and health professionals be trained in overweight and obesity to reduce attitudes, beliefs, and behaviors that directly and indirectly contribute to the stigmatization of patients living with overweight or obesity. |
| Strength of evidence: low | |
| Strength of recommendation: conditional | |
| Recommendation 3 | In adults living with obesity who will undergo bariatric surgery, the CCEO does not suggest using echocardiography as part of the standard preoperative evaluation. |
| Strength of evidence: low | |
| Strength of recommendation: conditional | |
| Recommendation 4 | In adults living with obesity who will undergo bariatric surgery, the CCEO recommends a preoperative diet to reduce weight before surgery and avoid perioperative complications. |
| Certainty of evidence: moderate | |
| Strength of recommendation: strong | |
| Recommendation 5 | In adults living with obesity who have undergone bariatric surgery, the CCEO suggests indicating physical activity and exercise as postsurgical non-pharmacological interventions since they have shown benefits in body weight, quality of life, and mental health. |
| Strength of evidence: low | |
| Strength of recommendation: conditional | |
| Recommendation 6 | In adults living with overweight or obesity, the CCEO recommends using a vegetarian diet as a non-pharmacological intervention to reduce weight and BMI. |
| Strength of evidence: moderate | |
| Strength of recommendation: strong | |
| In people living overweight or obesity, the CCEO suggests using a vegetarian diet as a non-pharmacological intervention for glycemic control and blood pressure management. | |
| Strength of evidence: low | |
| Strength of recommendation: conditional | |
| Recommendation 7 | In adults living with obesity who will undergo bariatric surgery, the CCEO suggests using postoperative calcium, iron, vitamin B12, and zinc supplementation to reduce the deficiency of these vitamins and minerals after surgery. |
| Certainty of evidence: low | |
| Strength of recommendation: conditional | |
| In adults living with obesity who will undergo bariatric surgery, the CCEO recommends daily postoperative vitamin D supplementation to reduce vitamin D deficiency after surgery. | |
| Strength of evidence: moderate | |
| Strength of recommendation: strong | |
| Recommendation 8 | In adults living with overweight or obesity, the CCEO suggests family intervention as a non-pharmacological measure for preventing overweight and obesity and weight control. |
| Strength of evidence: low | |
| Strength of recommendation: conditional | |
| Recommendation 9 | Within the non-pharmacological interventions in adults living with overweight or obesity, the CCEO suggests adding the mindfulness technique to cognitive behavioral therapy to improve weight control, decrease BMI, and improve behavior related to weight loss. |
| Strength of evidence: low | |
| Strength of recommendation: conditional | |
| Recommendation 10 | In adults living with class 1 obesity with comorbidities other than type two diabetes, the CCEO recommends surgical treatment as a treatment option. |
| Strength of evidence: moderate | |
| Strength of recommendation: strong | |
| Recommendation 11 | In adults with a BMI of 27 to 35, the CCEO recommends intragastric balloon therapy as an alternative to managing obesity. |
| Strength of evidence: moderate | |
| Strength of recommendation: strong | |
| Recommendation 12 | In adult women of childbearing age, living with overweight or obesity, the CCEO recommends within the non-pharmacological interventions to perform high-intensity exercise compared to other exercises. |
| Strength of evidence: moderate | |
| Strength of recommendation: strong | |
BMI, Body Mass Index. CCEO, Chilean Consortium for the Study of Obesity.