Give weight management advice to smokers who are trying to stop, NICE recommends
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Smokers who try to quit often gain weight |
Health care professionals such as pharmacists should offer weight management advice to people who are trying to stop smoking, according to a new clinical guideline released this week by the National Institute for Health and Clinical Excellence. People often put on weight when giving up smoking,
so the guideline says that health professionals should suggest services
that advise on obesity prevention and management, as well as offer general
advice on weight control and physical activity.
Alongside such lifestyle aspects of obesity prevention and management, “Guidance
on the prevention, identification, assessment and management of overweight
and obesity in adults and children” incorporates recommendations
previously offered by NICE on the use of orlistat (PJ, 17 March 2001,
p350) and sibutramine (PJ, 20 October 2001, p541).
What differs from NICE’s previous technology appraisals of the
two medicines is new recommendations on their use in children under specialist
care (see Panel below).
Orlistat and sibutramine recommendations
• Drug treatment is recommended for adults and children only after
dietary, exercise and behavioural approaches have been tried and
evaluated
• For children under the age of 12 years, drug treatment is not
recommended except in exceptional circumstances (where severe life-threatening
comorbidities exist) and under specialist supervision
• For children aged 12 to 18 years, drug treatment is only recommended
if physical or severe psychological comorbidities exist
• Orlistat and sibutramine should only be prescribed for obesity
in children by a specialist multidisciplinary team
• Orlistat is restricted to adults with a body mass index
(BMI) of 28 or more and with associated risk factors, or with a
BMI >=30
• Sibutramine is restricted to adults with a BMI >=27 and
other obesity-related risk factors such as type 2 diabetes, or
with a
BMI >=30 |
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