Updated NICE Guidance on Managing Overweight and Obesity

Dr Mudita Dhingra, Consultant Diabetologist, Shree Guru Kripa Endocrine Clinic, Kurukshetra

“The updated NICE guideline released in January 2025 emphasizes tailored lifestyle interventions, sensitive communication, and repeated referral opportunities, noting that while extra resources may be needed, the changes support long-term health benefits.”

In January 2025, NICE released an updated guideline related to management of overweight and obesity, expanding on the 2022 version. The guideline provides evidence-based recommendations for preventing and controlling overweight, obesity, and central adiposity across all age groups. Medicines for obesity were not included, as these are covered in separate NICE appraisals.

The recommendations considered the best available evidences, cost-effectiveness, and expert opinion when research is limited. They also highlight that obesity is influenced by social, economic, and environmental factors, and that discussions about weight must be sensitive and non-stigmatising.

The guideline emphasized the role of healthcare professionals in addressing the person’s primary health concern first to avoid diagnostic overshadowing. For adults with a BMI under 35, both BMI and waist-to-height ratio should be measured to assess central adiposity, especially in people from Black, Asian, and minority ethnic groups who may face a higher risk at lower BMI levels. This combined approach helps improve risk identification and ensures culturally appropriate care.

For children, the BMI z-score remains the most accurate measure for identifying risks of hypertension and type 2 diabetes. Waist-to-height ratio can be used as an additional measure to detect central adiposity. Age-specific BMI charts and centiles are recommended to ensure accurate classification.

The guidelines also stressed on the importance of proper communication with patients' family and how a positive and supportive attitude can focus on better quality of life and healthy growth.

The guideline also reinforces the importance of tailored lifestyle interventions, clear communication, and repeated opportunities for referral. It acknowledges that implementing these recommendations may require additional staffing, training, and resources, but it is expected to support long-term health benefits.

(Source: Practice Guidelines. Overweight and obesity management: summary of updated NICE guidance. BMJ. 2025 Dec 1;391:r2286. doi:10.1136/bmj.r2286.; https://www.bmj.com/content/391/bmj.r2286.full)