Obesity: Guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children
This is an extract from the guidance. The complete guidance is available at guidance.nice.org.uk/cg43
Changes since publication
December 2011: Minor maintenance
Amendment to Understanding NICE Guidance documents:
The Understanding NICE Guidance (UNG) versions 'Preventing obesity and staying a healthy weight' and 'Treatment for people who are overweight or obese' previously referred to The Obesity Awareness and Solutions Trust (TOAST) as a source of additional information and support for people wanting to stay a healthy weight or to lose weight. Please note that this organisation closed in December 2007 and is no longer able to provide such information and support, and so reference to the organisation has been removed. The remaining organisations listed in the UNG documents are still able to offer information about preventing or treating obesity.
CG43 Obesity replaces the following pieces of guidance:
Sibutramine (Reductil): marketing authorisation suspended:
On 21 January 2010, the MHRA announced the suspension of the marketing authorisation for the obesity drug sibutramine (Reductil). This follows a review by the European Medicines Agency which found that the cardiovascular risks of sibutramine outweigh its benefits. Emerging evidence suggests that there is an increased risk of non-fatal heart attacks and strokes with this medicine.
The MHRA advises that:
Prescribers should not issue any new prescriptions for sibutramine (Reductil) and should review the treatment of patients taking the drug.
Pharmacists should stop dispensing Reductil and should advise patients to make an appointment to see their doctor at the next convenient time.
People who are currently taking Reductil should make a routine appointment with their doctor to discuss alternative measures to lose weight, including use of diet and exercise regimens. Patients may stop treatment before their appointment if they wish.
NICE clinical guideline 43 recommended sibutramine for the treatment of obesity in certain circumstances. These recommendations have now been withdrawn and healthcare professionals should follow the MHRA advice.