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Clinical guidelines for overweight and obesity in England updated

We welcome the latest NICE guidelines for obesity in England recommending healthcare professionals show greater awareness of weight stigma and use new methods for identifying obesity.

Earlier this month the National Institute for Health and Care Excellence (NICE) updated its clinical guideline ‘Obesity: identification, assessment and management’. This is the first part of a process of wider consultations, updates, and an amalgamation of a range of obesity related guidelines due to take place next year.

The changes recommend that healthcare professionals now use waist to height ratio as well as body mass index (BMI) when calculating whether someone is living with obesity. They also recommend that greater steps are taken to ensure people do not feel stigmatised when discussing their weight.

We welcome this update and will be letting NICE know of the importance of improving access to weight management services in further updates so that everyone who needs to can access the right support for them.

Obesity is the biggest modifiable risk factor for type 2 diabetes and its prevalence has been rising. In England 28% of the population is living with obesity, and a further 36% are overweight.

The annual cost of obesity for the NHS is estimated to be £6.1 billion with a further £27 billion cost to the wider economy. Improving measures to both prevent obesity and treat it effectively are crucial for preventing type 2 diabetes and supporting those who are living with it to manage their diabetes more effectively.

More accurate measurements

The new recommendations from NICE are based on a range of evidence that show that, alongside BMI, waist to height ratio is a simple and effective way to assess and predict the risk of weight related conditions (including type 2 diabetes) for both men and women from all different ethnic groups.

Waist to height ratio takes direct measurements to calculate a person’s ‘central adiposity’ (waistline), giving a more accurate assessment of obesity and associated risks compared to BMI (a calculation based on weight and height). NICE also highlight that for different ethnic groups there is an increased associated risk at a lower weight which healthcare professionals should take into consideration. To take an accurate measurement of your own waistline you can find more information and a video guide on our website.

Increased awareness of weight-related stigma

NICE have also assessed and updated their recommendations on how healthcare professionals should bring up the topic of weight management with their patients in a supportive and non-stigmatising way. The update highlights the importance of asking permission before discussing it with patients and taking into account individual needs and preferences when discussing potential treatment options.

Further consultations will be looking at the referral criteria for bariatric surgery and ways to increase the uptake of weight management services in England. We will continue to tell NICE of the importance of everyone at risk of and living with diabetes to be able to access personalised, supportive, and non-stigmatising weight management services.

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