Obesity

ADULT

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Acute decompensation of cardiorespiratory/ renal function
    • Refer to local HealthPathways or local guidelines
    • Measure waist circumference in addition to calculating BMI if BMI <40
    • Lifestyle modification (increased activity, dietary, weight, smoking, alcohol)
    • Convey the message that even small amounts of weight loss may improve health and wellbeing
    • Use multicomponent approaches — these work better than single interventions
    • Refer appropriately to assist people to make lifestyle changes or for further intervention
    • Support a self-management approach and provide ongoing monitoring
    • Manage comorbidities when they are identified; do not wait until the person has lost weight
    • Offer people who are not yet ready to change the chance to return for further consultations when they are ready to discuss their weight again and willing or able to make lifestyle changes
    • Assess the person's readiness to adopt changes and person's confidence in making changes
    • Alternative services
    • Complex Obesity clinic does not offer Bariatric Surgery, please see Metabolic Surgery Suitability CPC
Minimum Referral Criteria
Category 1
(appointment within 30 calendar days)

This is only applicable where a dedicated obesity service exists

  • Patients with a serious obesity-related comorbidity^ that is likely to deteriorate quickly, if urgent weight loss is not achieved
  • Patients requiring urgent lifesaving operation/procedure that requires immediate weight loss for surgery/procedure to proceed (e.g. organ transplantation or assessment for organ transplantation, angiogram or cardiac surgery)

    ^Serious obesity related comorbidities include (not an exhaustive list):
    • severe liver disease
    • severe pulmonary hypertension
    • recurrent venous thromboembolism
    • intracranial hypertension
Category 2
(appointment within 90 calendar days)
  • Patients with severe obesity-related comorbidities such as (not an exhaustive list):
    • nephrotic range proteinuria or rapidly progressing renal impairment
    • chronic respiratory failure or obesity hypoventilation syndrome
    • severe OSA
    • recurrent cellulitis or venous ulcerations
    • recurrent hospital admissions for an obesity related condition
    • patients requiring weight loss for a semi-urgent or elective operation/procedure
    • poorly controlled diabetes with HbA1c > 9% and BMI >50
  • Patients with Prader Willi Syndrome (PWS) unless meet the criteria for Cat 1
Category 3
(appointment within 365 calendar days)
  • BMI >55 kg/m2 younger age i.e. 18-65 years without co-morbidities listed in Cat 1 or 2

Please insert the below information and minimum referral criteria into referral

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • Confirm patient's acknowledgement and readiness to undertake non-surgical weight loss measures
  • Height, weight, BMI
  • Details of any allied health support in place to assist with weight loss (any GPMP/TCA in place)
  • Ensure all comorbidities clearly stated
  • Current medications list
  • Details of all treatments offered and efficacy
  • Fasting lipids
  • FBC, HbA1c, urinary albumin creatinine ratio
  • TSH, ELFTs

3. Additional referral information Useful for processing the referral

  • Advise any risk factors assessed using lipid profile (preferable fasting), BP and HbA1c measurement
  • The person's lifestyle (diet and physical activity) and eating behaviour and/or any underlying causes for being overweight or obese

4. Request

  • Patient's Demographic Details

    • Full name (including aliases)
    • Date of birth
    • Residential and postal address
    • Telephone contact number/s – home, mobile and alternative
    • Medicare number (where eligible)
    • Name of the parent or caregiver (if appropriate)
    • Preferred language and interpreter requirements
    • Identifies as Aboriginal and/or Torres Strait Islander

    Referring Practitioner Details

    • Full name
    • Full address
    • Contact details – telephone, fax, email
    • Provider number
    • Date of referral
    • Signature

    Relevant clinical information about the condition

    • Presenting symptoms (evolution and duration)
    • Physical findings
    • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
    • Body mass index (BMI)
    • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
    • Current medications and dosages
    • Drug allergies
    • Alcohol, tobacco and other drugs use

    Reason for request

    • To establish a diagnosis
    • For treatment or intervention
    • For advice and management
    • For specialist to take over management
    • Reassurance for GP/second opinion
    • For a specified test/investigation the GP can't order, or the patient can't afford or access
    • Reassurance for the patient/family
    • For other reason (e.g. rapidly accelerating disease progression)
    • Clinical judgement indicates a referral for specialist review is necessary

    Clinical modifiers

    • Impact on employment
    • Impact on education
    • Impact on home
    • Impact on activities of daily living
    • Impact on ability to care for others
    • Impact on personal frailty or safety
    • Identifies as Aboriginal and/or Torres Strait Islander

    Other relevant information

    • Willingness to have surgery (where surgery is a likely intervention)
    • Choice to be treated as a public or private patient
    • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service.  Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.

    • A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.

    • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

Last updated: 2 December 2024

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