Obesity is defined as a disease process characterized by excessive body fat accumulation with multiple organ-specific consequences.The Scottish Intercollegiate Guidelines Network (SIGN) has provided evidence based recommendations on the prevention and treatment of obesity within the clinical setting, in children, young people and adults. The guideline development group has highlighted specific recommendations and good practice points that should be prioritized for implementation.

• Adults should be advised to reduce their intake of energy-dense foods, consumptionof fast foods and alcohol intake.
• Health care professionals should discuss willingness to change with their patients and then target weight loss intervention according to patient willingness around each component of behavior required for weight loss. e.g. specific dietary and/or activity changes. 
• Weight management programmes and support for weight loss maintenance, inclusive of physical activity, dietary change and behavioural components, should be implemented.
• Dietary interventions for weight loss should be calculated to produce 600 kcal/day energy deficit. Programmes should be tailored to the dietary preference of the individual patient.
• Bariatric surgery should be included as an overall clinical pathway for adult weight management.
• Health Boards should develop explicit care pathways offering a range of weight management interventions which may be targeted at the various subgroups of the population. Implementation should include a continuos improvement approachintegrating ongoing audit and evaluation.
• BMI centiles should be used to diagnose overweight and obesity in children.
• Treatment programmes for managing childhood obesity should incorporate behavior change components, be family based, involving at least one parent/ carer and aim to change the whole family's lifestyle. Programmes should target decreasing overall dietary energyu intake, increasing levels of physical activity and decreasing time spent in sedentary behaviors.
• Healthier eating, decreasing total energy intake, increasing habitual physical activity and reducing time spent in sedentary behavior are recommended for treatment in children.
• Children who may have serious obesity related morbidity that requires weight loss, and children with a suspected underlying medical cause of obesity should be referred to hospital or specialist paediatric services before treatment is considered.
• Orlistat should only be prescribed for severly obese adolescents with combordities or those with very severe to extreme obesity, attending a specialist clinic. There should be regular reviews throughout the period of use, including careful monitoring fo side effects.
• Bariatric surgery can be considered for post pubertal adolescents with very severe to extreme obesity and severe combordities.