National and International Clinical Guidelines for the Management of Obesity in Adults: A Systematic Review.

Abstract

Obesity is a leading risk factor for premature morbidity and mortality, and an increasing public health challenge. This review aimed to systematically identify and appraise national and international clinical guidelines for the management of obesity in adults. We systematically searched MEDLINE, CINAHL, Embase, and PsycINFO from 01/01/2019 to 06/01/2025. We conducted supplementary searches on websites of clinical guideline-producing organizations and other relevant institutional and evidence-based clinical resources. We included national and international guidelines on the management of obesity in adults aged ≥ 18 years that included recommendations on prespecified primary topics of interest, clearly stated the systematic approach and evidence base underpinning recommendations, and included a rating of the quality of evidence. The Appraisal of Guidelines for Research and Evaluation (AGREE) II tool and appraisal using the mEaningful VOice in the design and deLiVery of care (EVOLVE) framework were employed by two reviewers independently. Data were extracted by one reviewer, checked by another, and narratively synthesized. We identified 10 eligible clinical guidelines. The mean overall AGREE II score was 4.9/7 (SD: 1.22). Patients were involved in highlighting preferences, panel membership, reviewing drafts, and consensus meetings in most guidelines, and formulating/prioritizing questions, priority setting, and dissemination in a minority. The 2025 National Institute of Health and Care Excellence guideline on "Overweight and Obesity Management" displayed the most extensive scope and highest overall AGREE II score (7/7). This review will inform adaptation, as part of an ADAPTE process, for a prioritized National Clinical Guideline on the management of obesity in adults in Ireland.