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Commentary

Synopsis of the 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children

David C.W. Lau and ; for the Obesity Canada Clinical Practice Guidelines Steering Committee and Expert Panel
CMAJ April 10, 2007 176 (8) 1103-1106; DOI: https://doi.org/10.1503/cmaj.070306
David C.W. Lau
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  • Trial of pharmacotherapy duration should also be indicated.
    Martin G Dawes
    Posted on: 13 April 2007
  • Posted on: (13 April 2007)
    Page navigation anchor for Trial of pharmacotherapy duration should also be indicated.
    Trial of pharmacotherapy duration should also be indicated.
    • Martin G Dawes
    Dear Dr Lau et al, I was surprised by a lack of consistency of advice within the flow sheet for obesity in adults and children. The guidelines state quite clearly that if patients have not lost 0.5 Kg per week by 3-6 months after lifestyle changes then pharmacotherapy should be considered. However there is no similar time frame for the pharmacotherapy to be assessed or the degree of weight loss that should be considered sufficie...
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    Dear Dr Lau et al, I was surprised by a lack of consistency of advice within the flow sheet for obesity in adults and children. The guidelines state quite clearly that if patients have not lost 0.5 Kg per week by 3-6 months after lifestyle changes then pharmacotherapy should be considered. However there is no similar time frame for the pharmacotherapy to be assessed or the degree of weight loss that should be considered sufficient for continuation of therapy. This lack of advice in contrast to that provided in regard to lifestyle is puzzling. The 2006 National Institute for Clinical Excellence guidelines on obesity in adults (http://www.library.nhs.uk/diabetes/ViewResource.aspx?resID=213116&tabID=288&catID=5604) states that “pharmacotherapy should be continued beyond 3 months only if the person has lost at least 5% of their initial body weight since starting drug treatment”. Similarly the National Heart, Lung, and Blood Institute (NHLBI) guidelines (http://www.nhlbi.nih.gov/guidelines/obesity/prctgd_c.pdf) state that “If a patient has not lost 4.4 pounds (2 kg) after 4 weeks, it is not likely that this patient will benefit from the drug.” As a family physician this advice is critical to the review of patients with obesity who are being tested for their response to pharmacotherapy. This specific information about duration of the trial period for effectiveness is not contained in the documentation provided by the Canadian manufacturer and needs to be made explicit within the guideline. I strongly urge you to add a section limiting the trial period of pharmacotherapy in line with the limited period for assessing lifestyle modification. Yours sincerely Martin Dawes

    Conflict of Interest:

    None declared

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    Competing Interests: None declared.
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In this issue

Canadian Medical Association Journal: 176 (8)
CMAJ
Vol. 176, Issue 8
10 Apr 2007
  • Table of Contents
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  • Canadian Adverse Reaction Newsletter (p 1229 - 1236)

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Synopsis of the 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children
David C.W. Lau
CMAJ Apr 2007, 176 (8) 1103-1106; DOI: 10.1503/cmaj.070306

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Synopsis of the 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children
David C.W. Lau
CMAJ Apr 2007, 176 (8) 1103-1106; DOI: 10.1503/cmaj.070306
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