Behandeling van overgewicht en obesitas bij volwassenen: voorstel voor een richtlijn

- Overweight and obesity are rapidly increasing health problems, leading to considerable co-morbidity and increased mortality.

- In this article a Dutch guideline is proposed for the management of overweight and obesity, which in part is based on North American and European treatment proposals.

- After having assessed the degree of overweight and associated health risks, based on medical history, physical examination and laboratory investigations, a decision to start treatment can be made.

- First, consensus with regard to treatment goals has to be reached between doctor and patient, who has to be motivated to change his or her lifestyle. A modest (5-15 of pre-treatment weight) weight loss, which has to be sustained in the long term, is a desirable, realistic and achievable treatment goal for the majority of patients.

- Dietary management, an increased level of physical activity and behavioural advice are the most important basic treatment options in obesity. This advice is best provided as a multidisciplinary approach.

- In selected patients pharmacotherapy and in severe obesity bariatric surgery can be a useful addition to basic obesity management.