Bariatric treatments for adult obesity - Institute of Health Economics

the need for regular physical activity, and how to better regulate the lifestyle habits that need to bemodified. According to best practice recommendations, an effective weight management programrequires a specially adapted treatment structure offering:a range of bariatric treatments targeted at the various subgroups of the population;the availability of a multidisciplinary team; a specialized technical and equipment capacity.Long-term, if not lifelong, follow-up and continued supervision and support are necessary toprevent weight regain, monitor disease risks, and treat co-morbidities. Implementation of effectiveweight management programs should also include a continuous improvement approach integratingongoing audit and evaluation.To improve adherence to bariatric treatments and to enhance the success of long-term weightmanagement, patient-, provider-, and system-level barriers to effective weight control should beidentified and addressed. Patients’ readiness and motivation to make the necessary lifestyle changesare critical. Professional support and involvement are also necessary for sustained lifestyle andbehavioural changes to take place. An environment free of bias toward obesity is an importantrequirement in providing quality of care for individuals with obesity. The quality of bariatric carealso depends on healthcare professionals receiving appropriate training and accreditation and havingan awareness of available local resources. Although long-term multidisciplinary care and follow-upunderlies the best practice, it may present certain barriers to the implementation of evidence-basedweight management programs because of the lack of resources to support such programs within thecurrent environment of cost containment, and the lack of widespread insurance coverage for weightmanagement.The disease management and chronic care models may provide helpful templates for redesigningclinical practice in adult obesity management and for helping to overcome some of the barriers toeffective weight management. According to the reviewed literature, the most effective weightmanagement programs adopted a comprehensive disease management/chronic care approach thatcombines health promotion at the population level with clinical interventions and support. Thedevelopment of a multi-level obesity management network of mutually collaborating facilitiesinvolving primary care physicians, specialists in bariatric care, other specialists, and support groups isencouraged as a sensible response to the current demand for action.Bariatric treatments for adult obesity 40