Cited by 1,506Obesity, Physical Activity, DietObesity and Health PracticesPharmacology and Obesity Treatment

Obesity in adults: a clinical practice guideline

Open access
Wharton, Sean, Lau, David C.W., Vallis, Michael, Sharma, Arya M., Biertho, Laurent, Campbell-Scherer, Denise, Adamo, Kristi, Alberga, Angela +54 more·2020·Canadian Medical Association Journal

Abstract

KEY POINTS Obesity is a complex chronic disease in which abnormal or excess body fat (adiposity) impairs health, increases the risk of long-term medical complications and reduces lifespan.[1][1] Epidemiologic studies define obesity using the body mass index (BMI; weight/height2), which can stratify

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Registry

Crossref · 10.1503/cmaj.191707

Cites

88 of 88 references verified0 citation errors · 0 not checkable

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  • Scoring and staging systems and treatment algorithms for obesity are based on the presence of other diseases (often referred to as comorbidities), rather than clinical manifestations of obesity itself.

    “Typically, scoring and staging systems and treatment algorithms for obesity are based on the presence of other diseases (often referred to as comorbidities), rather than clinical manifestations of obesity itself.”

    From Definition and diagnostic criteria of clinical obesity (2025) · cites this paper as [18]

    The guideline’s discussion of the Edmonton Obesity Staging System says it considers metabolic, physical and psychological parameters to guide treatment, rather than relying on the presence of other diseases instead of clinical manifestations. Its Level 3 recommendation likewise proposes the system to assess obesity severity and guide decisions. The cited paper therefore does not support the claimed contrast. (LLM, conf=0.79)

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  • Current guidelines recommend adjunctive antiobesity medications to promote weight reduction, facilitate weight maintenance, and improve health outcomes in people with obesity.

    “Therefore, current guidelines recommend adjunctive antiobesity medications to promote weight reduction, facilitate weight maintenance, and improve health outcomes in people with obesity.2,3,4”

    From Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical Trial (2024) · cites this paper as [3]

    The Pharmacotherapy section recommends adjunctive medication for weight loss and weight-loss maintenance, but limits that recommendation to people with BMI ≥30 kg/m² or BMI ≥27 kg/m² with adiposity-related complications. The section does not explicitly recommend medication to improve health outcomes; the Nutrition and exercise section discusses health-related outcomes for combined interventions more broadly. (LLM, conf=0.82)

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  • Obesity is a chronic disease characterised by excess adiposity that impairs health and affects about 650 million people worldwide.

    “Obesity is a chronic disease characterised by excess adiposity that impairs health and affects about 650 million people worldwide [1, 2].”

    From What is the pipeline for future medications for obesity? (2025) · cites this paper as [1]

    The Abstract defines obesity as a chronic disease in which excess adiposity impairs health, and Step 1 repeats that definition. The Abstract says prevalence has increased worldwide, but it does not give the claimed figure of about 650 million people; a search for “650” found no matching passage. (LLM, conf=0.86)

    Experimental — accuracy not yet measured
  • Obesity is often associated with stigma, which impairs quality of life and increases morbidity.

    “Obesity is often associated with stigma, which impairs quality of life and increases morbidity.6”

    From Obesity Management in Adults (2023) · cites this paper as [6]

    The Abstract (page not provided) says people with obesity experience pervasive weight bias and stigma, which contributes to increased morbidity independently of weight or BMI. The guideline mentions reduced quality of life in its complications graphic, but does not clearly attribute that reduction to stigma rather than obesity more broadly. (LLM, conf=0.86)

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  • According to the USPSTF, the evidence supports referring all adults with obesity to intensive, multicomponent behavioral interventions for both weight reduction and weight maintenance.

    “According to the USPSTF, the evidence supports referring all adults with obesity to intensive, multicomponent behavioral interventions for both weight reduction and weight maintenance.”

    From Nutritional priorities to support <scp>GLP</scp> ‐1 therapy for obesity: A joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society (2025) · cites this paper as [98]

    Recommendation 58 in the Conclusion supports referral of people with overweight or obesity to personalized, multicomponent primary-care programs. The guideline does not attribute that recommendation to the USPSTF or specify intensive interventions for both weight reduction and maintenance; its Other guidelines section discusses a Canadian task force instead. No page number is available in our copy. (LLM, conf=0.84)

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Research works printed but not linked: 1

  1. [79]79. DistillerSR enterprise plan. Ottawa: Evidence Partners: Available: www. evidencepartners.com/products/distillersr-systematic-review-software/ (accessed 2020 May 22).

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Authors
Wharton, S., Lau, D. C. W., Vallis, M., Sharma, A. M., Biertho, L., Campbell-Scherer, D., Adamo, K., Alberga, A., Bell, R., Boulé, N., Boyling, E., Brown, J., Calam, B., Clarke, C., Crowshoe, L., Divalentino, D., Forhan, M., Freedhoff, Y., Gagner, M., Glazer, S., Grand, C., Green, M., Hahn, M., Hawa, R., Henderson, R., Hong, D., Hung, P., Janssen, I., Jacklin, K., Johnson-Stoklossa, C., Kemp, A., Kirk, S., Kuk, J., Langlois, M.-F., Lear, S., McInnes, A., Macklin, D., Naji, L., Manjoo, P., Morin, M.-P., Nerenberg, K., Patton, I., Pedersen, S., Pereira, L., Piccinini-Vallis, H., Poddar, M., Poirier, P., Prud’homme, D., Salas, X. R., Rueda-Clausen, C., Russell-Mayhew, S., Shiau, J., Sherifali, D., Sievenpiper, J., Sockalingam, S., Taylor, V., Toth, E., Twells, L., Tytus, R., Walji, S., Walker, L., & Wicklum, S.
Affiliations
  • Alberta Health Services (CA)
  • Dalhousie University (CA)
Venue
Canadian Medical Association Journal
Published
2020-08-03
Volume
192
Issue
31
Pages
E875-E891
ISSN
  • 0820-3946 (ISSN-L)
  • 1488-2329
OpenAlex
W3046790675
Cited by
1,506
References
88
Citations by year
2026: 218 · 2025: 284 · 2024: 331 · 2023: 290 · 2022: 226 · 2021: 139 · 2020: 15 · 2014: 1
FWCI
125.27
Type
journal article
Language
en
Open access
Locations
  • Canadian Medical Association Journal (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Eli Lilly and Company
  • AstraZeneca
  • PepsiCo
  • Almond Board of California
  • Sunovion
  • Dairy Farmers of Canada
  • Nestlé Health Science
  • Valeant Pharmaceuticals International
  • Canadian Cardiovascular Society
  • Diabetes Canada
  • European Food Safety Authority
  • Glycemic Index Foundation
  • Loblaw Companies Limited
  • Physicians Committee for Responsible Medicine
  • Soy Nutrition Institute
  • Society for Endocrinology
  • European Foundation for the Study of Diabetes
  • University of Toronto
  • Novo Nordisk
  • International Nut and Dried Fruit Council
  • Bausch Health
  • International Sweeteners Association
  • Health Canada
  • Canadian Institutes of Health Research
  • Obesity Canada
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
  • Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
Keywords
obesity, adult obesity, body mass index, adiposity, obesity treatment, chronic disease, lifespan reduction
MeSH terms
Adult, Canada, Female, Humans, Male, Obesity, Pregnancy, Primary Health Care, Body Mass Index

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