Medical and Health Benefits

Severe and complicated obesity demands greater weight loss to control secondary medical consequences

Weight management guidelines to support medical and health benefits 

  • Previous weight management guidelines have been aimed at those with BMI>30kg/m2, and universally adopted a 5-10% weight-loss and maintenance target, derived from the 1996 SIGN Management of Obesity guideline target of 5-10kg [SIGN 1996]. 
  • There has been some confusion between targets set as kg or % changes however  The 2010 SIGN Management of Obesity guideline set a new weight-loss and maintenance target of >15% for those with BMI>35kg/m2, or with BMI>30kg/m2 and serious medical complications such as type 2 diabetes[SIGN 2010]. 
  • A >15kg loss with Very Low Energy Diet (VLED) of 400-800kcal/day in people with established type 2 diabetes is known to normalise both glucose and insulin within 8 weeks [Anderson et al 2003; Wing et al 1987; Lim et al 2011].
  • A recent randomised controlled trial of bariatric surgery, (compared with conventional medical care), where a mean 21% weight-loss led to complete remission of type 2 diabetes two years later in 73% of patients [Dixon et al 2008].  Extrapolating published audit data suggests that intentional 15kg loss might even normalise the reduced life expectancy of overweight type 2 diabetes patients [Lean et al 1990].