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Weight loss surgery and exercise advice can tackle obesity and type 2 diabetes, says NICE

27 November 2014 - 9:50am

Overweight people with type 2 diabetes should be offered weight loss surgery, along with a package of follow-up care that could include physiotherapy.

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Follow-up care packages should include exercise advice as well as dietary and nutritional support

This is the message from the National Institute for Health and Care Excellence (NICE) in updated clinical guidance published today.

The guideline offers best practice advice on the care and treatment of overweight and obese people, and new guidance on the role of weight loss surgery and follow-up care.

It states that patients who have bariatric surgery should receive a multidisciplinary follow-up care package for a minimum of two years.

This should include:

  • physical activity advice and support
  • monitoring for co-morbidities
  • dietary and nutritional assessment, advice and support

John Wilding, a consultant physician in diabetes, endocrinology and general medicine at Aintree University Hospitals NHS trust, helped develop the guidance.

He told Frontline: ‘Physiotherapists have a lot to offer and can play a fundamental role in supporting people to lose weight and get more active. This is especially the case for severely obese patients, who often have joint and mobility problems.

‘Just seeing someone who trains people in a gym is not appropriate for these individuals, because they have other co-morbidities related to their weight.

‘Physios have a skill set that allows them to develop a tailored programme of exercises that can allow people to move more freely and more actively, and help support their weight loss.’

Treating type 2 diabetes

NICE says research shows that an estimated 60 per cent of patients with type 2 diabetes achieve remission from the condition after receiving gastric bypass surgery.

As a result, the guideline advises that all people with recent onset type 2 diabetes and a body mass index (BMI) of 35 or over should be referred for consideration for bariatric operations.

And it suggests that people with type 2 diabetes and a lower BMI of 30-35 should also be offered an assessment for weight loss surgery.

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