About the consensus statement

How the clinical consensus statement was developed

The Heart Foundation led the development of the consensus statement in collaboration with expert members of the Taskforce. The statement was based on a review of published literature and an environmental scan and was developed through a structured process to distil practical guidance based on evidence informed expert consensus. It addresses common clinical challenges and highlights rapidly emerging evidence, with a strong focus on clinical management to support informed, evidence-based care.

Clinical scope

The clinical scope of the consensus statement was prepared by the Heart Foundation project team with direction and input from the Taskforce. The scope was reviewed, refined and signed off by the Taskforce.

The Taskforce agreed on the following 14 clinical scoping questions:

1. How should clinical obesity and overweight be defined and characterised to support accurate diagnosis and risk assessment for the Australian population?
2. What is the association between overweight or obesity and the risk of experiencing a CV event – in the primary and secondary prevention setting – in adults?
3. In adults living with overweight or obesity, how do structured weight management interventions – compared to standard care or no intervention – impact CV outcomes?
4. What is the impact of overweight or obesity on the diagnosis, clinical management and outcomes for people living with or at high risk of CVD?
5. What are the unique clinical considerations for the management of obesity or overweight in people living with or at high risk of CVD?
6. In adults living with overweight or obesity and CVD or at high risk of CVD, what nutritional interventions support weight loss and improve CV outcomes or risk factors?
7. In adults living with overweight or obesity and CVD or at high risk of CVD, what physical activity interventions (including type, time and intensity) support weight loss and improve CV outcomes or risk factors?
8. In adults living with overweight or obesity and CVD or at high risk of CVD, which pharmacological therapies are effective in achieving weight loss and improving CV outcomes and risk factors?
9. What is the impact of bariatric surgery (focusing on the common techniques in Australia: gastric bypass, gastric sleeve, lap band or gastric banding) on CVD outcomes, morbidity and long-term or sustained improvements in complications of obesity?
10. In adults living with overweight or obesity from culturally and linguistically diverse communities, how do tailored or integrated management strategies improve CV outcomes, weight reduction and overall health outcomes?
11. In First Nations people living with overweight or obesity, how do tailored or integrated management strategies improve CV outcomes, weight reduction and overall health outcomes?
12. In adults living with overweight or obesity who have mental health conditions, how do tailored or integrated management strategies improve CV outcomes, weight reduction, and overall health outcomes?
13. In adults living with overweight or obesity from rural and remote communities, how do tailored or integrated management strategies improve CV outcomes, weight reduction and overall health outcomes?
14. In adults living with overweight or obesity from low socioeconomic status, how do tailored or integrated management strategies improve CV outcomes, weight reduction and overall health outcomes?

Out of scope

The Taskforce agreed that the following areas were out of scope for the consensus statement:

• detailed advice for children and adolescents
• very detailed recommendations on lifestyle (e.g. diet and physical activity)
• detailed system/environment level factors – e.g. food supply chain, food availability, built environment
• detailed advice on obesity, overweight and eating disorders
• detailed advice on surgical procedures
• detailed consideration of complementary medicines
• detailed or new economic analysis.

Evidence review and environmental scan

To address the clinical scoping questions identified above, a targeted evidence review and accompanying environmental scan were independently commissioned. Dr Shelley Keating from the University of Queensland undertook this work.

Unlike the Heart Foundation’s clinical guidelines, this consensus statement did not apply the GRADE methodology or involve undertaking new systematic reviews. It also did not seek to address broader policy, environmental or social issues. The statement does not intend to replace the forthcoming National Health and Medical Research Council obesity guidelines but rather complements them with more detailed guidance to address the specific clinical considerations in people living with overweight/obesity with established CVD, or at high risk of CVD.

See Evidence Review section for more information.

Developing the recommendations

The consensus statement was developed through a rigorous and transparent process, underpinned by published evidence and expert clinical judgment. The multidisciplinary membership of the Taskforce ensured a breadth of perspective and expertise. Clinical recommendations and/or narrative pieces were developed to address each of the clinical scoping questions.

Evidence to recommendation template

The evidence-to-recommendation template provides a structured framework for translating evidence into clinical advice. It includes dedicated sections where the following are documented:

• Recommendations and their strength of advice

• Rationale for the recommendations, narrative summary and practice points
• A brief summary of benefits and harms, weighing desirable and undesirable outcomes
• Certainty of evidence, including relevance and missing data
• Preferences and values, reflecting variability in an individual’s priorities
• Resources and other considerations, such as out-of-pocket costs, feasibility in the Australian context and accessibility across diverse communities

Strength of advice

To support the consistency and integrity of the recommendations, a structured framework for strength of advice was specifically developed to guide the evaluation of evidence and formulation of advice (Table 1). This framework was adapted from the European Society of Cardiology’s Scientific Documents Policy.1

Based on evidence quality and consensus among the Taskforce members, the strength of advice is both evidence-based and practical. Generally, the more high-quality studies and robust research designs included in an analysis, the stronger its evidence rating. Systematic reviews, meta-analyses and randomised controlled trials (RCTs) typically represent the highest level of evidence due to their rigorous methodology and strong indications of effectiveness.2

Table 1. Strength of advice hierarchy

Drafting the consensus statement

The Heart Foundation project team brought together the evidence-to-recommendation templates signed off by each subgroup to draft the consensus statement. The first draft was reviewed and approved by the Taskforce prior to targeted public consultation.

Following targeted consultation, the consensus statement was updated and final content approved by the Taskforce.

Targeted consultation

Targeted public consultation was conducted between 16 February and 9 March 2026, to seek feedback on the draft consensus statement prior to finalisation. The draft was circulated to a targeted group of stakeholders, including experts in cardiology, endocrinology and diabetology, bariatric surgery, general practice, First Nations health, epidemiology, nutrition and dietetics, exercise physiology, physiotherapy, pharmacy, public health and research, as well as representatives from peak health bodies, government and consumer peak bodies. Consultation was conducted within a defined scope, focusing on the clarity, balance, and clinical applicability of the draft.

A total of 833 individual pieces of feedback were received via an online form from 34 organisations and 13 individual contributors. All feedback was initially reviewed by the project team to determine whether it was in or out of scope. For feedback that was considered in scope, the project team determined whether it should be accepted, accepted with amendment, escalated to the Taskforce, noted, considered for implementation or rejected (giving rationale). This process was guided by the Taskforce Co-Chairs and broader Taskforce at regular meetings. Feedback considered outside the agreed scope was noted but not incorporated. Key changes to the statement resulting from targeted consultation were deliberated by the Taskforce, and the final document was approved following incorporation of feedback.

For a summary of targeted consultation feedback, see Appendix 2: Developing the clinical consensus statement

Conflicts of interest

The Heart Foundation and members of the Taskforce acknowledge the importance of both transparency and appropriate management of conflicts of interest.

Conflicting interests were considered within a framework of both:

• (i) the relationship (direct or indirect) of the participating individual to any third party with interest in the topic under consideration during the development process of the consensus statement
• (ii) the nature (financial and non-financial) of the potential conflict.

Conflicting interests among the subgroups required appropriate management to ensure clinical recommendations were not compromised. Processes employed by the Heart Foundation project team aimed to ensure the integrity of the Taskforce and to strike an appropriate balance between the existence of interests in a topic under review and the expertise required to make sound and meaningful recommendations.

More information on conflicts of interest management and a summary of all disclosures can be found in Appendix 3: Conflicts of interest