Appropriate guidance is lacking in long-term nutritional monitoring and support
The National Health and Medical Research Council (NHMRC) Clinical practice guidelines for the management of overweight and obesity were released in early June 2013, replacing the 2003 version, intended for use by specialists and general practitioners.1 A multidisciplinary committee oversaw the guideline development process, aiming to systematically identify and evaluate evidence. In my view, this process has failed with regard to the section dealing with bariatric surgery, thereby failing severely obese Australians and those caring for them.
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- 1. National Health and Medical Research Council. Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. Melbourne: NHMRC, 2013. http://www.nhmrc. gov.au/_files_nhmrc/publications/attachments/n57_obesity_guidelines_131003.pdf (accessed Nov 2013).
- 2. Koffman BM, Greenfield LJ, Ali II, Pirzada NA. Neurologic complications after surgery for obesity. Muscle Nerve 2006; 33: 166-176.
- 3. Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient – 2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. Endocr Pract 2013; 19: 337-372.
- 4. Grima M, Middleton S, Dixon JB. Bariatric surgery for the treatment of severe complex obesity: an update. Nutr Diet 2013; 70: 172-174.
- 5. Shannon C, Gervasoni A, Williams T. The bariatric surgery patient — nutrition considerations. Aust Fam Physician 2013; 42: 547-552.
I act as a consultant for Allergan, Inc. and Metagenics. I am a member of the Optifast medical advisory board for Nestlè Australia; I have received honoraria from iNova Pharmaceuticals for organising an obesity summit, and I have received research grants from Allergan, Inc. for investigator-initiated research. None of these entities had any input into the current perspective.