SIGN Management of Obesity Guideline Development Group, NHS Tayside, Public Health, Kings Cross, Dundee DD3 8EA, UK.
Proc Nutr Soc. 2010 May;69(2):195-8. doi: 10.1017/S0029665110000066. Epub 2010 Mar 5.
The problem of obesity in Scotland has reached epidemic proportions and this reality is recognised at Scottish Government level. The financial impact of treating obesity and obesity-related disease is substantial and in Scotland the cost was estimated at pound171 x 10(6) in 2001 but only a small proportion of this estimate included weight-loss interventions. The Scottish Intercollegiate Guidelines Network (SIGN) define clinical guidelines as 'systematically developed statements to help practitioner and patient decisions' that 'provide recommendations for effective practice in the management of clinical conditions where variations in practice are known to occur and where effective care may be known not to occur'. The evidence base for successful interventions has progressed since the publication by SIGN of Obesity in Scotland: Integrating Prevention with Weight Management in 1996 and Management of Obesity in Children and Young People in 2003. In 2007 SIGN commissioned a review of these two publications. In 2006 the National Institute for Health and Clinical Excellence (NICE) published a comprehensive obesity guideline and to avoid duplication of effort SIGN used the ADAPTE guideline adaptation framework to utilise and update evidence tables produced by NICE (where appropriate) as a basis for considered judgement. The new SIGN guideline is due for publication in 2010 and addresses children, young people (<18 years old) and adults. It will provide evidence-based recommendations on primary prevention of obesity (defined as intervention when individuals are at a healthy weight and/or overweight to prevent or delay the onset of obesity) within the clinical setting and treatment by lifestyle measures, drugs and surgery.
苏格兰的肥胖问题已经达到了流行的程度，这一现实在苏格兰政府层面得到了承认。治疗肥胖症和与肥胖相关疾病的财务影响是巨大的，在苏格兰，2001 年的成本估计为 17.1 亿英镑，但这一估计中只有一小部分包括减肥干预措施。苏格兰校际指南网络（SIGN）将临床指南定义为“帮助医生和患者决策的系统制定的声明”，这些声明“为临床情况下的有效实践提供建议，在这些情况下，实践中的差异是已知的，而有效的护理可能是未知的”。自 SIGN 于 1996 年出版《苏格兰肥胖症：将预防与体重管理相结合》和 2003 年出版《儿童和青少年肥胖症管理》以来，成功干预的证据基础已经有所进展。2007 年，SIGN 委托对这两份出版物进行了审查。2006 年，国家健康与临床卓越研究所（NICE）发布了一份全面的肥胖症指南，为了避免重复工作，SIGN 使用了 ADAPTE 指南适应框架，利用和更新了 NICE 制作的证据表（在适当的情况下）作为审议判断的基础。新的 SIGN 指南将于 2010 年发布，涉及儿童、青少年（<18 岁）和成年人。它将为临床环境中的肥胖症一级预防（定义为当个体处于健康体重和/或超重时进行干预，以预防或延迟肥胖的发生）以及通过生活方式措施、药物和手术进行治疗提供基于证据的建议。
