WIREDGOV

Obese people with recently diagnosed type 2 diabetes should be assessed for weight loss surgery – it is good for patients and cost saving for the NHS.

More than a quarter of adults are now classified as obese and a further 42% of men and a third of women are overweight. It is an immense problem for society – with huge personal health cost to individuals and an enormous financial cost to the NHS.

NICE has updated its guideline on the identification, assessment and management of overweight and obesity. Since the original recommendations were published in 2006 there is more evidence available on the best ‘follow up’ care for people who have undergone weight loss surgery and the role of surgery for people recently diagnosed with type 2 diabetes. The guideline also considers more information on the effectiveness and safety of very-low-calorie diets in helping people lose weight.

Commenting on the newly updated guideline, Professor Mark Baker, Centre for Clinical Practice director, said: “As a nation we are getting heavier. The number of people classified as obese has nearly doubled over the last 20 years and continues to rise. Obesity is directly linked to type 2 diabetes, fatty liver disease, cancer, high blood pressure, heart disease, stroke, arthritis and it affects people’s mental health. The financial implications of obesity are huge – 10% of the NHS budget is used to treat diabetes and its complications alone. It is a major issue, if not the major issue, for the health service in the coming years.

“NICE has published a range of guidelines to help prevent obesity and to help people lose weight. This guideline focuses on the clinical aspects – what a doctor should do to help an obese or overweight person. It sets out clearly what help and treatments should be offered and in what order.”

This newly updated NICE guideline says that very-low-calorie diets should only be used in certain circumstances; it includes new recommendations on weight loss surgery for people with type 2 diabetes and on follow up after surgery.

Professor John Wilding, Professor of Medicine and Honorary Consultant Physician in Diabetes, Endocrinology and General Medicine, University of Liverpool and Aintree University Hospitals NHS Foundation Trust, said:“Obesity has different causes – for some people it is down to lifestyle, for others it is genetics, but for most it is somewhere in between. But, whatever the reason, everyone who has a weight problem should be focusing on making changes to their diet and lifestyle. Weight loss surgery is not a quick fix or easy option, and although effective, it isn’t the answer for everyone. At the moment only 1% of people eligible for surgery actually have it; most people should try diet and exercise first. However, if someone is obese and they are diagnosed with type 2 diabetes it is really important that their doctor talks to them about the benefits undergoing surgery could provide for them.

“The new guideline also looked at very-low-calorie diets – after considering how well they work and if the weight loss can be sustained, we have recommended that they should not be used routinely for people who are obese. But we are not ruling them out entirely, they may be considered for people who have a clinical need to lose weight quickly, such as before joint replacement surgery.”

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