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ObesityApr 8, 2022

Physios urged to respond to NICE guidance on obesity, drawn up with input from Grace OMalley

Physiotherapists have a little more than a month to comment on national guidance on tackling obesity, which was published in draft form today (8 April) by the National Institute for Health and Care Excellence (NICE). 

The deadline for responding to the updated NICE guidance, titled Obesity: identification and classification of overweight and obesity, is 11 May. The final set of guidance is scheduled for publication on 8 September.

The guideline urges healthcare professionals to ask for permission before starting discussions with people that are linked to being overweight, obese or central adiposity, and to ensure they do so in a sensitive and positive manner.

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People should ensure their waist size is less than half of their height, the NICE guidance says


According to the guidance, people should ensure their waist size is less than half of their height. For the first time, this update encourages adults with a body mass index (BMI) below 35 kg/m² (obesity class 2) to measure their own waist-to-height ratio.

Using the waist-to-height ratio with BMI can help to provide a practical estimate of central adiposity (the accumulation of fat around the abdomen) to help to assess and predict health risks - such as type 2 diabetes, hypertension or cardiovascular disease.

NICE added the waist-to-height ratio to its draft guideline after looking at evidence from several studies which showed that, alongside BMI, it could be used to assess and predict weight-related conditions in all ethnicities and sexes.

We are now looking for views from the healthcare professionals and the public on the proposed recommendations in the guideline before final publication [Paul Chrisp, NICE]

Grace O’Malley

A Dublin-based physiotherapist with an international reputation in the field of obesity is one of 18 ‘core members’ of the NICE committee that drew up the guidance. Grace O’Malley is described as being aStAR research lecturer and principal investigator in the Obesity Research and Care Group.

Dr O’Malley is secretary of the European Association for the Study of Obesity (EASO), a federation of professional membership associations from 36 European countries.

The EASO website states that Dr O’Malley ‘leads the W82GO Child and Adolescent Weight Management Service delivering assessment and treatment for childhood obesity at Children’s Health Ireland at Temple Street [Dublin] and is committed to ensuring children and adolescents with obesity have equal access to evidence-based care'.

It adds that EASO aims to be the ‘voice of the European obesity community, promoting action through collaboration in advocacy, communication, education and research'.

For more information on Dr O’Malley, visit: https://easo.org/executive-committee/dr-grace-omalley

The guideline also recommends, in line with international guidance, using lower BMI thresholds for overweight and obesity for people from South Asian, Chinese, other Asian, Middle Eastern, Black African, or African-Caribbean family compared to the general population.

Paul Chrisp, director for centre for guidelines at NICE, said: ‘Our updated draft guideline offers people a simple and effective way of measuring their weight so they can understand the factors that could impact on their health and take action to address them.

‘Our committee found that a clear benefit of using the waist-to-height ratio is that people can easily measure it themselves, interpret the results, and seek medical advice if they are at increased health risk. Dr Chrisp added: ‘We are now looking for views from the healthcare professionals and the public on the proposed recommendations in the guideline before final publication.’


the prevalence of obesity in adults in England is estimated to be 28 per cent, with more than one person in three (36 per cent) deemed to be overweight , according to the 2019 Health Survey for England

the current costs of obesity in the UK are £6.1 billion to the NHS and £27 billion to wider society, according to government estimates

To respond to the NICE guidance, visit: https://www.nice.org.uk/guidance/indevelopment/gid-ng10284/consultation/html-content

Author: Ian A McMillan
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