Table 3.

General recommendations to improve the treatment of obesity in the clinical care delivery system in Mexico

	Recommendations
1.	Update the Mexican clinical practice guidelines with the collaboration of national experts in obesity management, government health authorities and international experts. It is recommended that the Diabetes Prevention Program (DPP) protocol be used as the program to promote lifestyle change considering the availability of materials for its application and the evidence of efficacy and effectiveness on body weight of adults with obesity.
2.	These guidelines should define the role of each health care provider. They should also clearly describe dietary management, physical activity, behavioral strategies, frequency of consultations (with broad flexibility according to needs: face-to-face, online, telephone, group, individual), and follow-up visits, pharmacotherapy and bariatric surgery. Important topics should also be included, such as stigmatization and obesity, how to initiate a conversation about weight, weight regain, among others.
3.	The primary care setting should have, as far as possible, interdisciplinary teams (including nutritionists or psychologists skilled in behavioral change) and the basic infrastructure for the diagnosis and treatment of obesity.
4.	Train primary health care providers in these clinical practice guidelines, establish mechanisms of evaluation and feedback to achieve their implementation. Also establish mechanisms to reward and recognize trained providers, as well as clinics with positive results.
5.	Conduct a pilot study of this project in a municipality or state, evaluate the results and make appropriate adjustments if needed. Once there are positive results, disseminate it on a larger scale and evaluate the effectiveness of the program.