Interpretation of the European Practical and Patient-Centred Guidelines for Adult Obesity Management in Primary Care —2019

doi:10.12114/j.issn.1007-9572.2019.00.649

Abstract

Abstract: Obesity is an important public health issue worldwide.And its related complications impose heavy burden on society.General practitioners play a central role in the prevention and control of obesity.The European Practical and Patient-Centred Guidelines for Adult Obesity Management in Primary Care released in January 2019，provides systematic recommendations for the management of adult obesity specifically tailored to European general practitioners.This paper interprets the highlights of the guidelines for Chinese general practitioners.

Key words: Obesity, Europe, Primary care, Disease management, Guideline

摘要： 肥胖现已成为我国乃至全球重要的公共卫生问题，其相关的并发症为社会带来了沉重的疾病负担。全科医生在国内外均是肥胖防控的核心，2019年1月发表的《欧洲实践指南：初级医疗中成年人肥胖的管理》，为欧洲初级医疗全科医生的成年人肥胖管理提出了系统的建议。本文针对该指南亮点结合我国全科医生的工作进行解读。

关键词: 肥胖症, 欧洲, 初级医疗, 疾病管理, 指南

ZHOU Fangli,LI Sheyu. Interpretation of the European Practical and Patient-Centred Guidelines for Adult Obesity Management in Primary Care —2019　[J]. Chinese General Practice, 2019, 22(32): 3905-3909. DOI: 10.12114/j.issn.1007-9572.2019.00.649.
周方励,李舍予. 2019年《欧洲实践指南：初级医疗中成年人肥胖的管理》解读[J]. 中国全科医学, 2019, 22(32): 3905-3909. DOI: 10.12114/j.issn.1007-9572.2019.00.649.

References

［1］中华医学会内分泌学分会肥胖学组.中国成人肥胖症防治专家共识［J］．中华内分泌代谢杂志，2011，27（9）：711-717．DOI：10.3760/cma.j.issn.1000-6699.2011.09.003.
Obesity Group，Chinese Society of Endocrinology.Consensus of Chinese experts on adult obeisty［J］．Chinese Journal of Endocrinology and Metabolism，2011，27（9）：711-717．DOI：10.3760/cma.j.issn.1000-6699.2011.09.003.
［2］NCD Risk Factor Collaboration（NCD-RISC）．Worldwide trends in body-mass index，underweight，overweight，and obesity from 1975 to 2016：a pooled analysis of 2416 population-based measurement studies in 128.9 million children，adolescents，and adults［J］．Lancet，2017，390（10113）：2627-2642．DOI：10.1016/S0140-6736（17）32129-3.
［3］GARVEY W T，MECHANICK J I，BRETT E M，et al．American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity［J］．Endocr Pract，2016，22（Suppl 3）：1-203．DOI：10.4158/EP161365.GL.
［4］DURRER SCHUTZ D，BUSETTO L，DICKER D，et al．European practical and patient-centred guidelines for adult obesity management in primary care［J］．Obes Facts，2019，12（1）：40-66．DOI：10.1159/000496183.
［5］LEVIN M E，POTTS S，HAEGER J，et al．Delivering acceptance and commitment therapy for weight self-stigma through guided self-help：results from an open pilot trial［J］．Cogn Behav Pract，2018，25（1）：87-104．DOI：10.1016/j.cbpra.2017.02.002.
［6］PUHL R M，HEUER C A.The stigma of obesity：a review and update［J］．Obesity（Silver Spring），2009，17（5）：941-964．DOI：10.1038/oby.2008.636.
［7］CHRISTIE D，HUDSON L D，KINRA S，et al．A community-based motivational personalised lifestyle intervention to reduce BMI in obese adolescents：results from the Healthy Eating and Lifestyle Programme（HELP） randomised controlled trial［J］．Arch Dis Child，2017，102（8）：695-701．DOI：10.1136/archdischild-2016-311586.
［8］MIRKARIMI K，KABIR M J，HONARVAR M R，et al．Effect of motivational interviewing on weight efficacy lifestyle among women with overweight and obesity：a randomized controlled trial［J］．Iran J Med Sci，2017，42（2）：187-193.
［9］NJARDVIK U，GUNNARSDOTTIR T，OLAFSDOTTIR A S，et al．
Incorporating appetite awareness training within family-based behavioral treatment of pediatric obesity：a randomized controlled pilot study［J］．J Pediatr Psychol，2018，43（9）：1017-1027．DOI：10.1093/jpepsy/jsy055.
［10］SOFI F，ABBATE R，GENSINI G F，et al．Accruing evidence on benefits of adherence to the Mediterranean diet on health：an updated systematic review and meta-analysis［J］．Am J Clin Nutr，2010，92（5）：1189-1196．DOI：10.3945/ajcn.2010.29673.
［11］SABHARWAL S，ROOT M Z.Impact of obesity on orthopaedics［J］．J Bone Joint Surg Am，2012，94（11）：1045-1052．DOI：10.2106/JBJS.K.00330.
［12］SJ?STR?M L，RISSANEN A，ANDERSEN T，et al．Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients.European Multicentre Orlistat Study Group［J］．Lancet，1998，352（9123）：167-172．DOI：10.1016/s0140-6736（97）11509-4.
［13］中华医学会外科学分会甲状腺及代谢外科学组，中国医师协会外科医师分会肥胖和糖尿病外科医师委员会.中国肥胖和2 型糖尿病外科治疗指南（2019版）［J］．中国实用外科杂志，2019，39（4）：301-306．DOI：10.7504/CJPS.ISSN1005-2208.2014.11.01.
Thyroid and Metabolic Surgery Group，Chinese Society of Surgery；Obesity and Diabetes Surgery Board，Chinese Medical Doctor Association of Surgery.Chinese guidelines for surgical treatment of obesity and type 2 diabetes（2019）［J］．Chinese Journal of Practical Surgery，2019，39（4）：301-306．DOI：10.7504/CJPS.ISSN1005-2208.2014.11.01.
［14］CAMACHO P M，PETAK S M，BINKLEY N，et al．American Association of Clinical Endocrinologists and American College of Endocrinology clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis—2016［J］．Endocr Pract，2016，22（Suppl 4）：1-42．DOI：10.4158/EP161435.GL.
［15］SEIBERT T S，ALLEN D B，CARREL A L.Adolescent obesity and its risks：how to screen and when to refer［J］．J Clin Outcomes Manag，2014，21（2）：87-96.

[1]	HAN Congcong, QIU Xinyu, SHAN Chunfang, SONG Ning, CHEN Qingjie, MULADILI· Abudureheman, LI Xiaomei, YANG Yining, ZHAO Qian. Impact of Metabolic Obesity Phenotype on Long-term Prognosis after Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome [J]. Chinese General Practice, 2026, 29(21): 2950-2958.
[2]	ZHANG Ke, ZENG Xianchang, ZOLZAYA Enkhzaya, ZHU Yelin, HUANG Yiwen, LIU Zhenxiu, TAO Feng. Effect of Xiere Xingpi Yin on Eating Behaviors and Weight-related Outcomes in Patients with Obesity: a Randomized Controlled Trial [J]. Chinese General Practice, 2026, 29(20): 2759-2765.
[3]	REYILAI· Maimaiti, ZHOU Yiran, WU Yun, LIU Zhencheng, LU Yaoqin, WU Haiyan. Association between Novel Obesity Indicators and Cardiovascular Disease Risk in Hypertensive Patients [J]. Chinese General Practice, 2026, 29(20): 2836-2845.
[4]	CHENG Yu, HAN Shiyao, SUN Ping, XIANG Juan, YANG Hui, LI Dongze, ZHENG Li, LIAO Xiaoyang. Analysis of Socioeconomic and Demographic Challenges in Chronic Disease Management [J]. Chinese General Practice, 2026, 29(20): 2800-2807.
[5]	WU Zhen, XI Yaqi, HU Linlin. Characteristics of Policy Instrument Selection and Combination for Weight Management in China: a Content Analysis of National Policy Documents (2016-2025) [J]. Chinese General Practice, 2026, 29(20): 2766-2774.
[6]	CHEN Xiangyang, HUANG Hongmei, LI Sheyu. Prevention and Management of Adult Obesity: Progress and Trends from Six Keywords in 2025 [J]. Chinese General Practice, 2026, 29(20): 2753-2758.
[7]	CHEN Cunchuan, ZHANG Huifang, FAN Boyang, SUN Wenning, WANG Yingjie, ZHANG Ao, ZHAO Yang, WANG Haipeng. Construction of Evaluation Indicator System for Primary Care Doctors' Service Capability in Integration of Medical and Preventive Care [J]. Chinese General Practice, 2026, 29(19): 2705-2710.
[8]	ZHANG Huifang, CHEN Cunchuan, FAN Boyang, SUN Wenning, WANG Yingjie, ZHANG Ao, ZHAO Yang, WANG Haipeng. Study on the Service Capability of Primary Care Doctors to Integrate Medical and Preventive Services and Its Influencing Factors in Shandong Province [J]. Chinese General Practice, 2026, 29(19): 2711-2716.
[9]	TANG Lijuan, QI Qi, ZHANG Fan, GAO Yifu, CAO Yajing, YUE Fujuan, GAO Jinchai, LIU Xiaoli. Characterisation of the Prevalence of Overweight/Obesity among Residents Aged 18-44 Years in Hebei Province in 2013 and 2020 [J]. Chinese General Practice, 2026, 29(19): 2695-2704.
[10]	CHEN Qiulong, CHEN Jia, FANG Jing, DAI Wei, YANG Qing. Application Status and Research Progress of Observer-reported Outcome [J]. Chinese General Practice, 2026, 29(18): 2561-2570.
[11]	LI Yachan, YANG Yang, XU Qianting, KE Tingyu. Association between the Chinese Visceral Adiposity Index and Left Ventricular Diastolic Dysfunction in Type 2 Diabetes Mellitus [J]. Chinese General Practice, 2026, 29(18): 2482-2488.
[12]	LI Simin, ZHANG Tingting, WANG Kunbo, YANG Jianzhou, PING Weiwei. Effects of Exercise Dosage on Elderly Patients with Sarcopenia: a Meta-analysis [J]. Chinese General Practice, 2026, 29(17): 2400-2409.
[13]	SUN Xibin, LI Jiawei, GE Aoqi, YUAN Beibei. The Association between the Specialists Outreach and the Job Perception and Diabetes Management Competence of Primary Care Providers [J]. Chinese General Practice, 2026, 29(17): 2319-2325.
[14]	WANG Yang, JIN Hua, YANG Sen, YANG Hui, YU Dehua. Reconfiguring the Functional Features of Primary Care in a Non-gatekeeping Context: a 15-Year Mixed-methods Systematic Review from China [J]. Chinese General Practice, 2026, 29(16): 2140-2155.
[15]	Chinese Nutrition Society Obesity Prevention and Control Branch. Chinese Guidelines for Behavioral and Lifestyle Interventions for Obesity [J]. Chinese General Practice, 2026, 29(16): 2113-2139.