Researchers: Orly Tamir¹, Avraham Krasik¹, Roy Barnea², Rakefet Bachar³, Evgeny Marzon⁴, Moran Accos Carmel¹

Background: Rapid advances in obesity treatments and the high prevalence of obesity have led many countries to substantially update clinical guidelines. In Israel, treatment recommendations rely on international principles, but there are no explicit or structured local guidelines to inform treatment choice, which may contribute to persistently high obesity rates.

Objectives: To review leading international obesity guidelines, describe obesity treatment practices in Israel, and identify gaps between the practice in Israel and the various guidelines and treatment approaches.

Method: A multi-stage mixed-methods study that included a review of international guidelines, mapping of treatment strategies in Israel, and rating of treatment appropriateness by an expert panel for 75 representative cases drawn from the obesity registry of Leumit Health Services. Rating results were analyzed quantitatively and qualitatively and discussed with the experts to understand the considerations underlying their recommendations.

Findings: High variability was found among professionals, expressed as substantial disagreement in rating treatment appropriateness in real-life cases, particularly among patients with complex medical and socio-demographic profiles.
Beyond differences in clinical approaches, the variability is rooted in different perceptions to treatment targets and outcomes, staging of treatment modalities and options, and the comprehensiveness that obesity care should encompass (multidisciplinary, psychosocial, and digital components).

Conclusions: In the absence of obesity treatment framework, care may become inconsistent, treatment quality may vary, and excessive reliance may be placed on the identity of the provider and their individual judgment.

Recommendations: To develop an agreed-upon treatment framework that includes principles, goals, and success indicators; provides tools for patient-tailored decision-making; encourages the use of digital tools; strengthens structured documentation;
and improves communication with patients

Research end date: 01/2026