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2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults

2013; Lippincott Williams & Wilkins; Volume: 129; Issue: 25_suppl_2 Linguagem: Inglês

10.1161/01.cir.0000437739.71477.ee

1524-4539

Michael D. Jensen, Donna H. Ryan, Caroline M. Apovian, Jamy D. Ard, Anthony G. Comuzzie, Karen A. Donato, Frank B. Hu, Van S. Hubbard, John M. Jakicic, Robert F. Kushner, Catherine M. Loria, Barbara E. Millen, Cathy Nonas, F. Xavier Pi‐Sunyer, June Stevens, Victor J. Stevens, Thomas A. Wadden, Bruce M. Wolfe, Jack A. Yanovski,

Pharmacology and Obesity Treatment

HomeCirculationVol. 129, No. 25_suppl_22013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults Open AccessResearch ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissionsDownload Articles + Supplements ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toSupplementary MaterialsOpen AccessResearch ArticlePDF/EPUB2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in AdultsA Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society Michael D. Jensen, MD, Donna H. Ryan, MD, Caroline M. Apovian, MD, FACP, Jamy D. Ard, MD, Anthony G. Comuzzie, PhD, Karen A. Donato, SM, Frank B. Hu, MD, PhD, FAHA, Van S. Hubbard, MD, PhD, John M. Jakicic, PhD, Robert F. Kushner, MD, Catherine M. Loria, PhD, FAHA, Barbara E. Millen, DrPH, RD, Cathy A. Nonas, MS, RD, F. Xavier Pi-Sunyer, MD, MPH, June Stevens, PhD, Victor J. Stevens, PhD, Thomas A. Wadden, PhD, Bruce M. Wolfe, MD and Susan Z. Yanovski, MD Michael D. JensenMichael D. Jensen , Donna H. RyanDonna H. Ryan , Caroline M. ApovianCaroline M. Apovian , Jamy D. ArdJamy D. Ard , Anthony G. ComuzzieAnthony G. Comuzzie , Karen A. DonatoKaren A. Donato , Frank B. HuFrank B. Hu , Van S. HubbardVan S. Hubbard , John M. JakicicJohn M. Jakicic , Robert F. KushnerRobert F. Kushner , Catherine M. LoriaCatherine M. Loria , Barbara E. MillenBarbara E. Millen , Cathy A. NonasCathy A. Nonas , F. Xavier Pi-SunyerF. Xavier Pi-Sunyer , June StevensJune Stevens , Victor J. StevensVictor J. Stevens , Thomas A. WaddenThomas A. Wadden , Bruce M. WolfeBruce M. Wolfe and Susan Z. YanovskiSusan Z. Yanovski Originally published12 Nov 2013https://doi.org/10.1161/01.cir.0000437739.71477.eeCirculation. 2014;129:S102–S138is corrected byCorrectionOther version(s) of this articleYou are viewing the most recent version of this article. Previous versions: January 1, 2013: Previous Version 1 Table of ContentsPreamble and Transition to ACC/AHA Guidelines to Reduce Cardiovascular Risk S1031. Introduction/Scope of Guideline S1041.1. Rationale for Updating Obesity Clinical Guidelines S1061.2. CQ-Based Approach S1071.3. Organization of the Panel S1071.4. Document Review and Approval S1082. Obesity Recommendations and Algorithm S1082.1. Summary of Evidence-Based Recommendations S1082.2. Chronic Disease Management Model for Primary Care of Patients With Overweight and Obesity—Treatment Algorithm S1083. CQs and Corresponding ESs S1103.1. CQ1: Statement of the Question S1173.1.1. Weight Loss and Risk of Diabetes S1173.1.2. Weight Loss and Impact on Cholesterol/Lipid Profile S1183.1.3. Weight Loss and Hypertension Risk S1183.2. CQ2: Statement of the Question S1183.2.1. Current BMI Cutpoints and CVD-Related Risk and All-Cause Mortality S1193.2.2. Areas of Insufficient Evidence With Regard to Cutpoints for BMI and for Waist Circumference S1193.3. CQ3: Statement of the Question S1203.3.1. Overall Dietary Intervention and Composition—Creating Reduced Dietary Energy Intake S1203.3.2. Overall Dietary Intervention and Composition—Pattern of Weight Loss Over Time With Dietary Intervention S1203.3.3. Low-Fat Approaches S1213.3.4. Higher-Protein Approaches (25% to 30% of Energy) S1213.3.5. Low-Carbohydrate Approaches ( 100 people per treatment arm. CQ5 added some major studies published after 2009 that met the I/E criteria.Screened, by 2 independent reviewers, thousands of abstracts and full-text articles returned from the search to identify relevant original articles, systematic reviews, and meta-analyses. Rigorous validation procedures were applied to ensure that the selected articles met the pre-established detailed I/E criteria before being included in the final review results.Determined, by 2 independent raters on the methodology team, the quality of each included study (good, fair, and poor).Abstracted relevant information from the included studies into an electronic central repository database using common templates and types of data elements.Constructed detailed evidence tables, which organized the data from the abstraction database.Analyzed the evidence tables and constructed summary tables, which display the evidence in a manageable format to answer specific parts of each CQ.Used summary tables to develop ESs for each CQ. The quality of evidence for each ES was graded as high, moderate, or low on the basis of scientific methodology, scientific strength, and consistency of results. For CQ1 and CQ2, spreadsheets with relevant data from systematic reviews and meta-analyses were developed rather than summary tables.Used the graded ESs to write clinical recommendations, and graded the strength of each recommendation. Recommendations were graded as Strong Recommendation (Grade A), Moderate Recommendation (Grade B), Weak Recommendation (Grade C), Recommendation Against (Grade D), Expert Opinion (Grade E), or No Recommendation For or Against (Grade N).Performed G