Bariatric treatments for adult obesity - Institute of Health Economics

Clinical practice guidelines (CPGs) were included if they provided definitive recommendationsspecific to the diagnosis and management of adult obesity. An article was deemed to be a CPG if itmet all the following criteria:It contained the word ‘guideline’ or ‘recommendation’ in its title or introduction, orcontained specific guidance, in the form of advice or instructions, on how to diagnoseand/or manage adults (≥ 18 years, both genders) with obesity (of any duration or stage).It was developed by at least two authors.It used an evidence-based approach in the process of developing the guidance(recommendations, advice, or instructions were based on a systematic review of theliterature, were graded based on the strength of the supporting evidence, and reflected theconsensus of the experts involved in the development of the guidance). It described the evidence-based approach used for the development of recommendations,advice, or instructions.Only those publicly available, evidence-based CPGs developed by national bodies in Canada andother countries with developed market economies were considered.Consensus statements and/or position statements containing recommendations based solely onexpert opinion were included only if they were developed in Alberta.SOCIAL SYSTEMS AND DEMOGRAPHICS APPROACHThe social systems and demographics approach analysis summarizes available key information onthe use of bariatric treatments for adult obesity in Alberta and North America (mainly Canada). Thisanalysis was intended to describe the profile of adult obesity (definition, progression, epidemiology,and population dynamics of affected individuals in Alberta and in Canada) and patterns of care forthis condition (focusing on bariatric treatments recommended by evidence-based clinical practiceguidelines), as well as to identify potential inequities in health status or care across population groups.Also considered were social factors associated with the use of multidisciplinary programs involvingbariatric treatments for adult obesity in Alberta.Profile of IllnessAs a medical term, the term “obesity” describes a condition of excess body fat caused by animbalance between the amount of energy entering the body and the amount of energy leaving it.Obesity is the result of complex interactions between various factors including environmental (social,economic, and cultural), behavioural, hormonal, and genetic factors. It is a health problem, becauseit is associated with multiple health risks and organ-specific consequences, including type 2 diabetesmellitus (T2DM), cardiovascular disease, musculoskeletal problems, and certain forms of cancer.Over the past 30 years obesity has become one of the most prevalent conditions in countries withdeveloped market economies, and it is increasingly viewed as a societal issue (www.iotf.org, accessed23 July 2010; www.who.int/mediacentre/factsheets/fs311/en/index.html, accessed 23 July 2010). 1-15It affects individuals of all ages (children, adolescents, and adults) and both genders. It is recognizedas a major public health problem and has been identified as an epidemic by the World HealthOrganization (WHO) and medical organizations around the globe.Bariatric treatments for adult obesity – March 2012 3