Hopp til hovedinnhold

Overvekt og fedme

Sist oppdatert: Sist revidert:
Sist revidert av:


Definisjon:
Overvekt defineres som KMI 25,0-29,9 kg/m2, fedme grad I er KMI 30,0-34,9 kg/m2, fedme grad II er KMI 35,0-39,9 kg/m2 og fedme grad III er definert som KMI ≥40 kg/m2
Forekomst:
Hver femte nordmann har en kroppsmasseindeks (KMI) ≥30 kg/m2 (fedme)
Symptomer:
Symptomet er overvekt + ev. overvektsrelaterte tilleggs-symptomer som nedsatt funksjonsevne, redusert fysisk kapasitet, søvnapné, dyspepsi, halsbrann, sure oppstøt, symptomer på angst og depresjon, sosial isolasjon og redusert livskvalitet
Funn:
Klinisk funn er overvekt, ev. søvnapné, høyt blodtrykk, dyslipidemi, diabetes type 2, ikke-alkoholisk fettlever, gallesteinssykdom, PCOS, hjerte- og karsykdom, belastningslidelser i vektbærende ledd, angst, depresjon og overspisingslidelser
Diagnostikk:
Tilleggsundersøkelser: TSH og FT4, HbA1c, leverprøver, lipidstatus. Beregne fri testosteronindeks ved mistanke om PCOS
Behandling:
Først og fremst kalorirestriksjon for vektreduksjon (3-6 måneder), med økende grad av fysisk aktivitet for vektstabilisering (resten av livet). Hvis dette ikke er tilstrekkelig bør medikamentell behandling vurderes. Kirurgi aktuelt ved fedme grad III, eller grad II + tilleggssykdommer.
  1. Emerging Risk Factors Collaboration, Wormser D, Kaptoge S, et al. Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies. Lancet 2011; 377:1085. PubMed  
  2. World Health Organization (WHO). Body mass index - BMI www.euro.who.int  
  3. Folkehelseinstituttet. Overvekt og fedme. Folkehelserapporten 2017. Sist oppdatert 04.10.2017. Siden besøkt 20.02.2018. www.fhi.no  
  4. Kahn SE. The relative contributions of insulin resistance and beta-cell dysfunction to the pathophysiology of Type 2 diabetes. Diabetologia 2003; 46: 3-19. pmid:12637977 PubMed  
  5. Reilly JJ, Jackson DM, Montgomery C, Kelly LA, Slater C, Grant S, Paton JY . Total energy expenditure and physical activity in young Scottish children: mixed longitudinal study. Lancet 2004; 363: 211-2. PubMed  
  6. Júlíusson PB, Hjelmesæth J, Bjerknes R, Roelants M. Nye kurver for kroppsmasseindeks blant barn og unge. Tidsskr Nor Laegeforen. 2017 Oct 2;137(18). doi: 10.4045/tidsskr.17.0570. DOI  
  7. Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in Obesity Among Adults in the United States, 2005 to 2014. JAMA 2016; 315: 2284-91. pmid:27272580 PubMed  
  8. Kivimäki M, Lawlor DA, Singh-Manoux A, et al. Common mental disorder and obesity-insight from four repeat measures over 19 years: prospective Whitehall II cohort study. BMJ 2009; 339: b3765. PMID: 19808765 PubMed  
  9. Hall KD, Sacks G, Chandramohan D, et al. Quantification of the effect of energy imbalance on bodyweight. Lancet 2011; 378: 826-37. pmid:21872751 PubMed  
  10. Kumar S, Kelly AS. Review of Childhood Obesity: From Epidemiology, Etiology, and Comorbidities to Clinical Assessment and Treatment. Mayo Clin Proc 2017; 92: 251-65. pmid:28065514 PubMed  
  11. Forebygging, utredning og behandling av overvekt og fedme hos voksne. Nasjonale retningslinjer for primærhelsetjenesten. Oslo, Helsedirektoratet, 2011.
  12. World Health Organization. Body mass index-BMI. www.euro.who.int  
  13. Jacobs EJ, Newton CC, Wang Y, et al. Waist circumference and all-cause mortality in a large US cohort. Arch Intern Med 2010; 170: 1293-301. PubMed  
  14. Zembic A, Eckel N, Stefan N, et al. An Empirically Derived Definition of Metabolically Healthy Obesity Based on Risk of Cardiovascular and Total Mortality. JAMA Netw Open 2021; 4: e218505. doi:10.1001/jamanetworkopen.2021.8505 DOI  
  15. Nordang GBN, Busk ØL, Tveten K, et al. Next-generation sequencing of the monogenic obesity genes LEP, LEPR, MC4R, PCSK1 and POMC in a Norwegian cohort of patients with morbid obesity and normal weight controls. Mol Genet Metab 2017; 121: 51-6. pmid:28377240 PubMed  
  16. Norsk kvalitetsforbedring av laboratorieundersøkelser (Noklus). Anbefalte analyser ved utvalgte kliniske problemstillinger. Siden besøkt 11.03.2019. www.noklus.no  
  17. Den norske legeforening. Norsk plastikkirurgisk forening. Retningslinjer for plastikkirurgi i offentlig regi. Nettsiden lest 07.10.2019. beta.legeforeningen.no  
  18. Grief SN, Miranda RLF. Weight loss maintenance. Am Fam Physician 2010; 82: 630-34. PMID: 20842990 PubMed  
  19. Potter MB, Vu JD, Croughan-Minihane M. Weight management: What patients want from their primary care physicians. J Fam Pract 2001; 50: 513-8. PMID: 11401737 PubMed  
  20. Hjelmesæth J, Lund RS, Sagen JV, Valderhaug TG. Vektreduserende medisiner - for hvem, hvordan, hvor lenge?. Tidsskr Nor Legeforen 2022; 142: 511. doi:10.4045/tidsskr.22.0115 DOI  
  21. Madigan CD, Graham HE, Sturgiss E, et al. Effectiveness of weight management interventions for adults delivered in primary care: systematic review and meta-analysis of randomised controlled trials. BMJ 2022; 377: e069719. pmid:35636762 PubMed  
  22. Svendsen OL, Toubro S, Bruun JM, Linnet JP, Kroustrup JP. Retningslinjer for behandling af overvægt/fedme anno 2006. Ugeskr Læger 2006; 168: 180-2. PubMed  
  23. Dombrowski SU, Knittle K, Avenell A, et al. Long term maintenance of weight loss with non-surgical interventions in obese adults: systematic review and meta-analyses of randomised controlled trials. BMJ. 2014;348:g2646. PMID: 25134100 PubMed  
  24. Johnson F, Cooke L, Croke H, Wardle J . Changing perceptions of weight in Great Britain: comparison of two population surveys . BMJ 2008; 337: a494. PubMed  
  25. Wadden TA, Butryn ML, Hong PS, et al. Behavioral treatment of obesity in patients encountered in primary care settings: a systematic review. JAMA. 2014 ;312(17):1779- 91. PMID: 25369490 PubMed  
  26. Parretti HM, Aveyard P, Blannin A, et al. Efficacy of water preloading before main meals as a strategy for weight loss in primary care patients with obesity: RCT. Obesity (Silver Spring) 2015; 23: 1785-91. PMID: 26237305 PubMed  
  27. Johnston BC, Kanters S, Bandayrel K, et al. Comparison of weight loss among named diet programs in overweight and obese adults: a meta-analysis. JAMA 2014; 312: 923-33. pmid:25182101 PubMed  
  28. Liu D, Huang Y, Huang C, et al. Calorie Restriction with or without Time-Restricted Eating in Weight Loss. N Engl J Med 2022; 386: 1495-1504. pmid:35443107 PubMed  
  29. Lowe DA, Wu N, Rohdin-Bibby L, et al. Effects of Time-Restricted Eating on Weight Loss and Other Metabolic Parameters in Women and Men With Overweight and Obesity: The TREAT Randomized Clinical Trial. JAMA Intern Med 2020; 180: 1491-99. pmid:32986097 PubMed  
  30. Foster GD, Wyatt HR, Hill JO. Weight ant meetabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial. Ann Intern Med 2010; 153: 147-57. PMID: 20679559 PubMed  
  31. Eckel RH. Nonsurgical management of obesity in adults. N Engl J Med 2008; 358: 1941-50. PubMed  
  32. Shaw KA, Gennat HC, O'Rourke P, Del Mar C. Exercise for overweight or obesity. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD003817. DOI: 10.1002/14651858.CD003817.pub3 DOI  
  33. AAdland E, Anderssen SA. Effekt av fysisk aktivitet på vektreduksjon. Tidsskr Nor Legeforen 2013; 133: 37-40. doi:10.4045/tidsskr.12.0523 DOI  
  34. Kieffer SK, Nauman J, Syverud K, Selboskar H, Lydersen S, Ekelund U, Wisløff U. Association between Personal Activity Intelligence (PAI) and body weight in a population free from cardiovascular disease – The HUNT study. Lancet Reginal Health 2021. doi:10.1016/j.lanepe.2021.100091 DOI  
  35. Boutelle KN, Kirschenbaum DS. Further support for consistent self-monitoring as a vital component of successful weight control. Obes Res 1998; 6: 219-24. PubMed  
  36. Dong Z, Xu L, Liu H, et al. Comparative efficacy of five long-term weight loss drugs: quantitative information for medication guidelines. Obes Rev 2017; 18: 1377-85. pmid:29024559 PubMed  
  37. Tak YJ, Lee SY. Long term Efficacy and Safety og Anti-Obesity Treatment: Where do we stand? . Curr Obes Rep 2021; 10: 14-30. pmid:33410104 PubMed  
  38. Heymsfield SB, Wadden TA. Mechanisms, Pathophysiology, and Management of Obesity. N Engl J Med. 2017 Jan 19;376(3):254-266. PMID: 28099824. PubMed  
  39. Shi Q, Wang Y, Hao Q, et al. Pharmacotherapy for adults with overweight and obesity: a systematic review and network meta-analysis of randomised controlled trials. Lancet 2021. pmid:34895470 PubMed  
  40. Isaacs D, Prasad-Reddy L, Srivastava SB. Role of glucagon-like peptide 1 receptor agonists in management of obesity. Am J Health Syst Pharm. 2016 Oct 1;73(19):1493-507. PMID: 27521241. PubMed  
  41. Lundgren JR, Janus C, Jensen SBK, et al. Healthy weight loss maintenance with exercise, liraglutide, or both combined. N Engl J Med 2021 May 6; 384:1719. PMID: 33951361 PubMed  
  42. Wilding JPH, Batterham RL, Calanna S, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med 2021. pmid:33567185 PubMed  
  43. Wadden TA, Bailey TS, Billings LK, et al. Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy on Body Weight in Adults With Overweight or Obesity The STEP 3 Randomized Clinical Trial. JAMA 2021. pmid:33625476 PubMed  
  44. Rubino D, Abrahamsson N, Davies M, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity The STEP 4 Randomized Clinical Trial. JAMA 2021. pmid:PMID: 33755728 PubMed  
  45. Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide Once Weekly for the Treatment of Obesity, N Engl J Med. 2022. PMID: 35658024 PubMed  
  46. He L, Wang J, Ping F, et al. Association of Glucagon-Like Peptide-1 Receptor Agonist Use With Risk of Gallbladder and Biliary Diseases A Systematic Review and Meta-analysis of Randomized Clinical Trials. JAMA Intern Med 2022. pmid:35344001 PubMed  
  47. Greenway FL, Fujioka K, Plodkowski RA, et al. Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 2010; 376: 595-605. PubMed  
  48. Apovian CM, Aronne L, Rubino D et al; COR-II Study Group. A randomized, phase 3 trial of naltrexone SR/bupropion SR on weight and obesity-related risk factors (COR-II). Obesity 2013; 21: 935-43. pmid:23408728 PubMed  
  49. Wadden TA, Foreyt JP, Foster GD et al. Weight loss with naltrexone SR/bupropion SR combination therapy as an adjunct to behavior modification: the COR-BMOD trial. Obesity 2011; 19: 110-20. pmid:20559296 PubMed  
  50. Hollander P, Gupta AK, Plodkowski R, et al; COR-Diabetes Study Group. Effects of naltrexone sustained-release/bupropion sustained-release combination therapy on body weight and glycemic parameters in overweight and obese patients with type 2 diabetes. Diabetes Care 2013; 36: 4022-29. pmid:24144653 PubMed  
  51. FDA - USA. Belviq, Belviq XR (lorcaserin) by Eisai: Drug Safety Communication - FDA Requests Withdrawal of Weight-Loss Drug. Drug Safety Communication 13.02.2020 www.fda.gov  
  52. Courcoulas AP, Yanovski SZ, Bonds D, et al. Long-term outcomes of bariatric surgery: a National Institutes of Health symposium. BMJ. 2015;350:g6380. PMID: 25271405 PubMed  
  53. Colquitt JL, Pickett K, Loveman E, et al. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014 ;8:CD003641.pub4 Cochrane (DOI)  
  54. Ikramuddin S, Korner J, Lee WJ, et al. Lifestyle Intervention and Medical Management With vs Without Roux-en-Y Gastric Bypass and Control of Hemoglobin A1c, LDL Cholesterol, and Systolic Blood Pressure at 5 Years in the Diabetes Surgery Study. JAMA 2018; 319: 266-78. pmid:29340678 PubMed  
  55. Jakobsen GS, Småstuen MC, Sandbu R, Nordstrand N, Hofsø D, Lindberg M, Hertel JK, Hjelmesæth J. Association of bariatric surgery vs medical obesity treatment with long-term medical complications and obesity-related comorbidities. JAMA 2018; 319: 291-301. pmid:29340680 PubMed  
  56. Reges O, Greenland P, Dicker D, et al. Association of Bariatric Surgery Using Laparoscopic Banding, Roux-en-Y Gastric Bypass, or Laparoscopic Sleeve Gastrectomy vs Usual Care Obesity Management With All-Cause Mortality. JAMA 2018; 319: 279-90. pmid:29340677 PubMed  
  57. Merlotti C, Morabito A, Pontiroli AE. Prevention of type 2 diabetes: a systematic review and meta-analysis of different intervention strategies. Diabetes Obes Metab 2014; 16: 719-27. pmid:24476122 PubMed  
  58. Peterli R, Wölnerhanssen BK, Peters T, et al. Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss in Patients With Morbid Obesity: The SM-BOSS Randomized Clinical Trial. JAMA 2018; 319: 255-65. pmid:29340679 PubMed  
  59. Hofsø D, Hjelmesæth J. et al. Oseberg Study - in press. Lancet Diabetes and Endocrinology 2019.
  60. Salminen O, Helmiö M, Ovaska J, et al. Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss at 5 Years Among Patients With Morbid Obesity: The SLEEVEPASS Randomized Clinical Trial. JAMA 2018; 319: 241-54. pmid:29340676 PubMed  
  61. Aasheim ET, Mala T, Søvik TT, Kristinsson J, Bøhmer T. Kirurgisk behandling av sykelig fedme. Tidsskr Nor Lægeforen 2007; 127: 38-42. PubMed  
  62. Giske L, Stoinska-Schneider A, Arentz-HansenA et al. Fedmekirurgi ved diabetes type 2 og kroppsmasseindeks under 35. Rapport - 2018. Oslo: Folkehelseinstituttet; 2018. www.fhi.no  
  63. Helsedirektoratet. Diabetes. Nasjonal faglig retningslinje. Fedmekirurgi og diabetes type 2. Oslo, Helsedirektoratet 2018. www.helsedirektoratet.no  
  64. O'Brien PE, Dixon JB, Laurie C et al. Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program: a randomized trial. Ann Intern Med 2006; 144: 625-33. PMID: 16670131 PubMed  
  65. Chang SH, Stoll CR, Song J, et al. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003-2012. JAMA Surg 2013, Dec 18 . PMID: 24352617 PubMed  
  66. Søvik TT, Aasheim ET, Taha O, et al. Weight loss, cardiovascular risk factors, and quality of life after gastric bypass and duodenal switch. Ann Intern Med 2011; 155: 281-91. PMID: 21893621 PubMed  
  67. Dayyeh BKA, Maselli DB, Rapaka B, et al. Adjustable intragastric balloon for treatment of obesity: a multicentre, open-label, randomised clinical trial. Lancet 2021. pmid:34793746 PubMed  
  68. Nguyen NT, Slone JA, Nguyen XM, Hartman JS, Hoyt DB. A Prospective Randomized Trial of Laparoscopic Gastric Bypass Versus Laparoscopic Adjustable Gastric Banding for the Treatment of Morbid Obesity: Outcomes, Quality of Life, and Costs. Ann Surg 2009; 250: 631. PubMed  
  69. Schiavon CA, Bersch-Ferreira AC, Santucci EV. Effects of Bariatric Surgery in Obese Patients With Hypertension: The GATEWAY Randomized Trial (Gastric Bypass to Treat Obese Patients With Steady Hypertension). Circulation 2017. pmid:29133606 PubMed  
  70. Sjostrom L, Narbro K, Sjostrom CD, et al, for the Swedish Obese Subjects Study. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007; 357: 741-52. PMID: 17715408 PubMed  
  71. Syn NL, Cummings DE, Wang LZ, et al. Association of metabolic-bariatric surgery with long-term survival in adults with and without diabetes: A one-stage meta-analysis of matched cohort and prospective controlled studies with 174 772 participants.. Lancet 2021; 397: 1830. pmid:33965067 PubMed  
  72. ArterburnDE, Olsen MK, Smith VA, et al. Association between bariatric surgery and longterm survival. JAMA 2015; 313: 62-70. PMID: 25562267 PubMed  
  73. Aminian A, Wilson K, Al-Kurd A, et al. Association of Bariatric Surgery With Cancer Risk and Mortality in Adults With Obesity. JAMA 2022. pmid:35657620 PubMed  
  74. van Veldhuisen SL, Gorter TM, van Woerden G, et al. Bariatric surgery and cardiovascular disease: a systematic review and meta-analysis. Eur Heart J 2022. PMID: 35243488 PubMed  
  75. Steinbrook R. Surgery for severe obesity. N Engl J Med 2004; 350: 1075-9. PubMed  
  76. Poelemeijer YQM, Liem RSL, Våge V, et al. Gastric Bypass Versus Sleeve Gastrectomy Patient Selection and Short-term Outcome of 47,101 Primary Operations from the Swedish, Norwegian, and Dutch National Quality Registries. Ann Surg 2019. pmid:30921054 PubMed  
  77. Svensson PA, Anveden A, Romeo S, et al. Alcohol consumption and alcohol problems after bariatric surgery in the Swedish obese subjects study. Obesity (Silver Spring). 2013;21:2444-51. PMID: 23520203 PubMed  
  78. Bhatti JA, Nathens AB, Thiruchelvam D, et al. Self-harm Emergencies After Bariatric Surgery: A Population-Based Cohort Study. JAMA Surg 2016; 161: 226-32. PMID: 26444444 PubMed  
  79. Popov VB, Ou A, Schulman AR, et al.   The Impact of Intragastric Balloons on Obesity-Related Co-Morbidities: A Systematic Review and Meta-Analysis. Am J Gastroenterol. 2017. PMID: 28117361 PubMed  
  80. Tonstad S, Sundfør T, Myrvoll EA. Ernæringsstatus etter operativ behandling for fedme. Tidsskr Nor Lægeforen 2007; 127: 50-3. PubMed  
  81. Stein J, Stier C, Raab H, et al. Review article: The nutritional and pharmacological consequences of obesity surgery. Aliment Pharmacol Ther. 2014 ;40(6):582-609. PMID: 25078533 PubMed  
  82. Angeles PC, Robertsen I, Seeberg LT, Krogstad V, Skattebu J, Sandbu R, Åsberg A, Hjelmesaeth J. The influence of bariatric surgery on oral drug bioavailability in patients with obesity: A systematic review. Obes Rev 2019; 20: 1299-311. pmid:31232513 PubMed  
  83. Metoder för at fremja fysisk aktivitet: en systematisk litteraturöversikt. Stockholm: Statens beredning för medicinsk utvärdering; 2007. SBU-rapport 181.
  84. Sheperd TM. Effective management of obesity. J Fam Pract 2003; 52: 34-42. PubMed  
  85. Kramer CK, Zinman B, Retnakaran R. Are metabolically healthy overweight and obesity benign conditions? A systematic review and meta-analysis. Ann Intern Med 2013; 159: 758-69. PMID: 24297192 PubMed  
  86. Shanshan L, Shin HJ, Ding EL, van Dam RM. Adiponectin levels and risk of type 2 diabetes. A systematic review and meta-analysis. JAMA 2009; 302: 179-88. PMID: 19584347 PubMed  
  87. Kenchaiah S, Evans JC, Levy D, et al. Obesity and the risk of heart failure. N Engl J Med 2002; 347: 305-13. PubMed  
  88. The Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration . Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1.8 million participants. Lancet 2013. doi:10.1016/S0140-6736(13)61836-X DOI  
  89. Kyrgiou M, Kalliala I, Markozannes G et al. Adiposity and cancer at major anatomical sites: umbrella review of the literature. BMJ 2017. pmid:28246088 PubMed  
  90. Hildén K, Hanson U, Persson M, et al. Gestational diabetes and adiposity are independent risk factors for perinatal outcomes: a population based cohort study in Sweden. Diabet Med 2019; 36: 151-7. pmid:30698864 PubMed  
  91. Stenberg E, Szabo E, Agren G et al. Scandinavian Obesity Surgery Registry Study Group. Early complications after laparoscopic gastric bypass surgery: results from the Scandinavian Obesity Surgery Registry. Ann Surg 2014; 260: 1040-7. pmid:24374541 PubMed  
  92. Jacobsen HJ, Nergard BJ, Leifsson BG et al. Management of suspected anastomotic leak after bariatric laparoscopic Roux-en-y gastric bypass. Br J Surg 2014; 101: 417-23. pmid:24536012 PubMed  
  93. Stroh C, Köckerling F, Volker L et al. Results of More Than 11,800 Sleeve Gastrectomies: Data Analysis of the German Bariatric Surgery Registry. Ann Surg 2016; 263: 949-55. pmid:26727093 PubMed  
  94. Lalor PF, Tucker ON, Szomstein S, Rosenthal RJ. Complications after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis 2008; 4: 33. pmid:17981515 PubMed  
  95. Flegal KM, Graubard BI, Williamson DF, Gail MH. Cause-specific excess deaths associated with underweight, overweight, and obesity. JAMA 2007; 298: 2028-37. PMID: 17986696 PubMed  
  96. Prospective Studies Collaboration, Whitlock G, Lewington S, Sherliker P, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet 2009; 373: 1083-96. PubMed  
  97. Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories. A systematic review and meta-analysis. JAMA 2013; 309: 71-82. PMID: 23280227 PubMed  
  • Jøran Hjelmesæth, professor ved Avdeling for endokrinologi, sykelig overvekt og forebyggende medisin, Universitetet i Oslo. Senterleder ved Senter for sykelig overvekt i Helse Sør-Øst, Sykehuset i Vestfold, og leder ved Nasjonalt råd for ernæring

Tidligere fagmedarbeidere

  • John Cooper, spesialist i allmennmedisin og indremedisin, Medisinsk avdeling, Sentralsjukehuset i Rogaland, Stavanger
  • Stein Vaaler, overlege dr. med., Senter for Klinisk Epidemiologi, Rikshospitalet, Universitetet i Oslo