Weight Loss

ATS: Summary of Guidelines on Weight Management in OSA

The American Thoracic Society has published a new clinical practice summary of its guidelines on weight management for the treatment of adult obstructive sleep apnea (OSA).1 

The guidelines were originally created by a multidisciplinary team to assess the impact of various weight loss strategies on OSA and were released in September 2018.2 Now, a group of 9 experts has compiled a summary of the guidelines for clinicians. Included in the summary are the guidelines’ key takeaways, including:

  • Patients with OSA who have a body mass index (BMI) of 25 kg/m2 or more should participate in a comprehensive lifestyle intervention program that includes a reduced-calorie diet, increased physical activity, and behavioral counseling. 
  • Patients with OSA who have a BMI of 25 kg/m2 or more, whose weight has not improved with a comprehensive weight-loss lifestyle intervention program, and who do not have any contradictions, should be evaluated for anti-obesity pharmacotherapy. 
  • Patients with OSA who have a BMI of 35 kg/m2 or more, whose weight has not improved with a comprehensive weight-loss lifestyle intervention program, and who do not have any contradictions, should be referred for bariatric surgery evaluation.

 

When recommending these weight management strategies to patients with OSA who are obese or overweight, the authors note that it is imperative that clinicians discuss all options with their patients and include patients in the decision-making process.

—Colleen Murphy

References:

  1. Billings ME, Krishnan V, Su G, et al. Clinical practice guideline summary for clinicians: the role of weight management in the treatment of adult obstructive sleep apnea. Ann Am Thorac Soc. 2019; 16(4):405-408. https://doi.org/10.1513/AnnalsATS.201810-708CME. 
  2. Gerchufsky M. New guideline: patients with sleep apnea may not realize they are obese [published online September 17, 2019]. Pulmonology Consultant. https://www.consultant360.com/exclusive/pulmonology/sleep-apnea/new-guideline-patients-sleep-apnea-may-not-realize-they-are-obese.