Obesity: identification, assessment and management

NICE guideline CG189

We found 244 relevant studies in a search for systematic reviews, randomised controlled trials and observational studies published between 1 July 2011 and 27 October 2017. We also included 3 relevant studies identified by members of the guideline committee who originally worked on this guideline.

We also considered evidence identified in previous surveillance of the guideline. This included 144 studies identified by search. From all sources, we considered 391 studies to be relevant to NICE guideline CG189.

NICE guideline PH46

We found 66 relevant studies in a search for systematic reviews, randomised controlled trials and observational studies published between 1 January 2012 and 12 January 2018.

Ongoing research

We checked for relevant ongoing research; of the ongoing studies identified, 2 studies related to NICE guideline PH46 and 3 studies related to NICE guideline CG189 were assessed as having the potential to change recommendations; therefore we plan to check the publication status regularly, and evaluate the impact of the results on current recommendations as quickly as possible.

See appendix A1 for PH46 and appendix A2 for CG189 for details of all evidence considered, with references.

NICE guideline CG189

Sixteen stakeholders commented on the proposal to update the guideline. Fourteen agreed with the decision and 2 noted that they had no comments on the proposals.

Comments included a suggestion to review the recommendation relating to very low energy diets. However, other stakeholders indicated that the results of longer term ongoing research are required before establishing an impact on the guideline in this area. In addition, extensions to the scope were suggested. However, no evidence to address the suggested questions was identified. Ongoing or published studies and policy documents were identified by the consultees, some of which were not identified during the surveillance review and will be considered in the update process.

NICE guideline PH46

Fifteen stakeholders commented on the proposal to withdraw NICE guideline PH46 and incorporate the recommendations into NICE guideline CG189: 14 agreed with the decision; and 1 disagreed with the decision.

Several comments suggested that the proposal to merge the guidelines would be pragmatic, practical and would save practitioner time. Comments suggested that the proposed merge into a main obesity guideline would give more impact and create widespread awareness of the recommendations for black, Asian and other minority ethnic groups.

Stakeholders also commented that the proposed merge of guidelines should ensure that all the information from NICE guideline PH46 continues to be included. Comments suggested that consideration should be given to highlight the tailored assessment and interventions specific for this population when recommendations are incorporated into NICE guideline CG189. The surveillance review proposal includes a decision to ensure that no information is lost from NICE guideline PH46 when the guideline is withdrawn.

Stakeholders also agreed with the proposal to include active case finding to detect obesity in black, Asian and other minority ethnic groups.

Several stakeholders commented that men, children and young people, and subgroups within black, Asian and other minority ethnic populations should not be generalised when using thresholds. The current recommendations already contain separate thresholds for these demographic categories and the proposed merge of guidelines includes the decision to maintain these. During the update of NICE guideline CG189, evidence for separate thresholds for children and young people from black, Asian and other minority ethnic populations to have specific recommendations will be considered.

The stakeholder who disagreed with the decision to merge guidelines did not provide any further comments or reasons.

See ensuring that published guidelines are current and accurate in developing NICE guidelines: the manual for more details on our consultation processes.