Abstract
Objectives: Obesity causes morbidity and mortality and also impairs the quality of life in humans. Clinical practice guidelines are well established to treat the obese population with or without comorbidities in all the age groups. Obesity in adults is a risk factor for metabolic disorders including Type-2 diabetes mellitus, hypertension, dyslipidemia, etc. Hence, this review has compared the various international clinical practice guidelines for the management of obesity in adults.
 Methods: Four articles were included in the qualitative synthesis after the systematic review of the literature obtained from PubMed/MEDLINE and Web of Sciences. Diagnosis and various interventions including lifestyle, pharmacotherapy and bariatric surgery are compared for the management of obesity in adults.
 Results: The diagnosis is crucial since the criteria to determine overweight/obesity is still under debate due to inconclusive evidence. Various interventions including diet, exercise, behavior, drug therapy, and surgery are being recommended currently for the management of obesity. However, ethnicity and culture play a major role in diagnosis and also interventions. Moreover, personalizing the interventions according to the subject will make sense and offers success in the management of obesity.
 Conclusion: Diagnosis and the intervention should be subject oriented based on ethnicity, culture and patient characteristics. In this connection, many longitudinal studies warranted to specify the diagnostic and management criteria for adults among the various ethnic populations across the world.
Highlights
Obesity is a major risk factor causing morbidity and mortality with the association of diabetes, hypertension, hyperlipidemia, obstructive sleep apnea, and osteoarthritis [1]
Abdominal obesity which is a greater amount of fat in the abdomen or trunk compared with the hips and lower extremities has been associated with increased risk for Type 2 diabetes mellitus, hypertension, and heart disease in both men and women [4,5]
AACE/ACE: American Association of Clinical Endocrinologists and American College of Endocrinology, BMI: Body mass index, NHMRC: National Health and Medical Research Council. *Lifestyle therapy – reduce calorie healthy meal plan/physical activity/behavioral interventions, **weight loss medications, consider if lifestyle therapy fails to prevent progressive weight gain (BMI >27), bariatric surgery if BMI ≥35, ***lifestyle change – reduced energy intake, physical activity, and behavioral change; weight loss medication if BMI >28, bariatric surgery if BMI >40 the same selected for critical appraisal was made on the full text and four retained and included in this review (Fig. 1)
Summary
Obesity is a major risk factor causing morbidity and mortality with the association of diabetes, hypertension, hyperlipidemia, obstructive sleep apnea, and osteoarthritis [1]. Abdominal obesity which is a greater amount of fat in the abdomen or trunk compared with the hips and lower extremities has been associated with increased risk for Type 2 diabetes mellitus, hypertension, and heart disease in both men and women [4,5]. Various guidelines established already for the management of overweight/obesity for adults across the world based on BMI and waist circumference (WC); the recommended interventions from these guidelines yet to be compared. The objective of this narrative review is to compare the established guidelines for the management of overweight/obesity among the adults will provide the new insights into the health-care professionals for making appropriate intervention to improve the quality of life and to prevent the complications
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