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CLINICAL GUIDELINES

Pharmacologic and Surgical Management of Obesity in Primary Care: A Clinical Practice Guideline from the American College of Physicians

Vincenza Snow, MD; Patricia Barry, MD, MPH; Nick Fitterman, MD; Amir Qaseem, MD, PhD, MHA; Kevin Weiss, MD, MPH, for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians*

5 April 2005 | Volume 142 Issue 7 | Pages 525-531

This guideline is based on the evidence report and accompanying background papers developed by the Southern California Evidence-Based Practice Center. The American College of Physicians nominated this topic to the Agency for Healthcare Research and Quality Evidence-Based Practice Center program as part of a concerted effort to complement the guidelines of the U.S. Preventive Services Task Force. The College recommends that all clinicians refer to the Task Force recommendations as part of an overall strategy for managing overweight and obesity, which should always include appropriate diet and exercise for all patients who are overweight or obese. The intent of this guideline is to provide recommendations based on a review of the evidence on pharmacologic and surgical treatments of obesity. The target audience is all clinicians caring for obese patients, defined as a body mass index of 30 kg/m² or greater. This guideline is not intended to be used by commercial weight loss centers or for direct-to-consumer marketing by manufacturers and does not apply to patients with body mass indices below 30 kg/m².

*This paper, written by Vincenza Snow, MD; Patricia Barry, MD, MPH; Nick Fitterman, MD; Amir Qaseem, MD, PhD, MHA; and Kevin Weiss, MD, MPH, was developed for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians (ACP): Kevin Weiss, MD, MPH (Chair); Mark Aronson, MD; Patricia Barry, MD, MPH; Donald E. Casey Jr., MD, MPH, MBA; J. Thomas Cross Jr., MD, MPH; Nick Fitterman, MD; E. Rodney Hornbake, MD; Douglas K. Owens, MD; and Katherine D. Sherif, MD. Approved by the ACP Board of Regents in October 2004.

Author and Article Information

From the American College of Physicians, Philadelphia, Pennsylvania; Merck Institute of Aging and Health, Washington, DC; and Hines VA Hospital, Hines, and Northwestern University, Chicago, Illinois.

Annals of Internal Medicine encourages readers to copy and distribute this paper, providing such distribution is not for profit. Commercial distribution is not permitted without the express permission of the publisher.

Note: Clinical practice guidelines are guides only and may not apply to all patients and all clinical situations. Thus, they are not intended to override clinicians' judgment. All ACP clinical practice guidelines are considered automatically withdrawn, or invalid, 5 years after publication, or once an update has been issued.

Disclaimer: The authors of this article are responsible for its contents, including any clinical or treatment recommendations. No statement in this article should be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

Grant Support: Financial support for the development of this guideline comes exclusively from the ACP operating budget.

Potential Financial Conflicts of Interest: Employment: P. Barry (Merck Institute of Aging and Health); Stock ownership: P. Barry (Merck & Co., Inc.); Grants received: P. Barry (Merck Co. Foundation).

Requests for Single Reprints: Vincenza Snow, MD, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106; e-mail, vincenza{at}acponline.org.

Current Author Addresses: Drs. Snow and Qaseem: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.

Dr. Barry: Merck Institute of Aging and Health, 1100 New York Avenue NW, Washington, DC 20005.

Dr. Fitterman: North Shore Medical Group, 120 New York Avenue, Huntington, NY 11743.

Dr. Weiss: Hines Veterans Administration Hospital (151H), PO Box 5000, Hines, IL 60141.

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