Patients who are overweight, associated with a waist hip circumference at risk, and/or other forms of co-morbidity should receive assessment with regards to diet, exercise and lifestyle with the aim to reduce 5-10% of their weight. Pharmacotherapy should be offered to obese patients or those with a BMI>27 kg/m2 associated with 2 or more forms of co-morbidity when a conservative approach has failed. Medication should be discontinued when, after 3 months, a weight reduction of 5% has not been reached.

No properly designed clinical trials exist that support the use of phytotherapy. These products are not free from adverse effects.

In the case of morbid obesity (BMI>40 kg/m2) or BMI > 35 kg/m2 associated with co-morbidity and failure of conservative management, bariatric surgery remains an option. This procedure should be performed in reference centres after an adequate selection is made and posterior nutritional follow up is possible.

Authors:

• Mª Estrella Petrina et al. Clinical Nutrition and Dietetics Section. Hospital de Navarra. Spain.