Supplementary Material for: To What Extent Do Clinical Practice Guidelines for Chronic Diseases Embrace Current Obesity Management Guidance? A Qualitative Content Analysis

Introduction: Obesity is a chronic, progressive, and recurring disease that contributes significantly to multimorbidity across Europe. Despite the publication of numerous clinical practice guidelines (CPGs) for obesity, many chronic disease guidelines for obesity related diseases such as diabetes, MASLD, heart disease, obstructive sleep apnea do not integrate contemporary understandings of obesity as an adiposity-based disease requiring direct management in its own right. The objective of this qualitative content analysis was to evaluate the extent to which recent chronic disease CPGs align with current evidence-based obesity guidance. Methods: A working group convened by the European Association for the Study of Obesity reviewed 13 chronic disease CPGs published since 2019. Guidelines were assessed using nine predefined criteria based on leading obesity CPGs. Data were extracted and content analysis was used to identify gaps and opportunities across the chronic disease CPGs. Results: Three key themes were identified: (1) inconsistent scientific/medical conceptualization of obesity, (2) limited integration of evidence-based obesity management guidance, and (3) minimal inclusion of person-centred care principles. Most guidelines treated obesity as a risk factor, not a disease, and lacked reference to contemporary obesity frameworks or person-first language. Conclusion: Greater alignment across CPGs is essential to improve obesity care within multimorbidity management. Collaborative, cross-specialty approaches are recommended to harmonize clinical guidance and promote integrated, stigma-free care.