A reinforced coordinated pathway system for complex adult obesity has just been made official by a decree published in the Official Journal. Reimbursed by Health Insurance, this program, which includes individual or collective interventions, aims to strengthen patient autonomy while guaranteeing continuous traceability of care, transmitted to the attending physician.
An obesity situation is said to be complex depending on its severity (BMI ≥ threshold 35 kg/m2, class II) or the accumulation of associated factors: somatic or psychiatric complications or comorbidities, functional impact, significant impact on daily life and quality of life, etc. The new reinforced coordinated pathway system for complex adult obesity has just been made official by a decree published in the Official Journal of March 4, World Obesity Day. Resulting from a successful experiment, it now allows reimbursement by Health Insurance for complete multidisciplinary care.
Structures such as nursing homes, health centers or hospitals can carry out this project provided they include a doctor specializing in obesity to coordinate care. So far tested in Burgundy-Franche-Comté, its deployment throughout France was one of the measures of the 2026-2030 roadmap for the management of obesity, announced in mid-January by the Minister of Health.
This care pathway is based above all on rigorous coordination ensured by a multidisciplinary team under the responsibility of a doctor specializing in obesity. The objective of this program, which includes individual or collective interventions, aims to strengthen patient autonomy while guaranteeing continuous traceability of care, transmitted to the attending physician.
- The system begins with a complete multidimensional assessment which analyzes the clinical and biological aspects as well as the psychological, social and behavioral dimensions of the patient.
- At the end of this assessment, the development of a personalized program gives rise to targeted interventions, in terms of psychology, diet or even adapted physical activity.
- Follow-up is then punctuated by systematic re-evaluations at 6, 12 and 24 months in order to adjust the care and prevent any disruption in the course.
In-depth assessment of the severity of obesity
Concretely, the inclusion of a patient in this pathway requires a medical prescription as well as a thorough assessment of the severity of obesity according to the criteria of the High Authority of Health. A “minimal” core team then supports the patient, bringing together around the coordinating doctor a nurse, a dietician, a clinical psychologist and an adapted physical activity professional (massager-physiotherapist, adapted physical activity teacher, psychomotor therapist and occupational therapist).
Under the authority of the obesity specialist, several organizations are possible, whether it is a single authorized structure or two jointly authorized structures, as long as they guarantee no loss of opportunity for patients and ensure care that complies with the requirements of these specifications. “Even if he does not report to the core team, the patient’s treating physician is constantly associated with the reinforced coordinated pathway for complex obesity in adults,” further specifies the decree. “As such, the responsible structure ensures that they are informed, involved in relevant clinical decisions and ensures, with their agreement, the regular transmission of the necessary information. All of these conditions must ensure the continuity, quality and safety of patient care.” This system also works closely with regional sectors, in particular the forty-two specialized obesity centers* spread across the national territory.
Its deployment is also managed by the Regional Health Agencies via calls for applications. Regions with a high prevalence of obesity must launch their procedures before June 30, 2026. For other regions, this deadline is December 31, 2026. The decree finally specifies the terms of fixed-rate remuneration, thus facilitating cooperation between self-employed health professionals and coordination structures.
Les chiffres de l'obésité en France
L’étude la plus récente publiée en 2024 (OFEO) estime que 48.8% de la population française est en surpoids ou en obésité. Si on s’intéresse plus spécifiquement à l’obésité : près de 18% de la population adulte française est en obésité (soit 10 millions de personnes).
La prévalence de l’obésité varie selon l’âge et le sexe, les femmes sont plus touchées que les hommes. Son augmentation est plus forte chez les 18-25 ans, notamment en ce qui concerne l’obésité sévère et complexe.
Elle est également plus élevée dans certains départements. Enfin, il existe une corrélation entre obésité et catégories sociales défavorisées, et cette tendance s’est accentuées au cours des dernières années.
Source : Centres Spécialisés de l’Obésité de France.
* Since 2001, the National Nutrition and Health Program (PNNS) has been trying to prevent the increase in overweight and obesity in France. In 2011 the Ministry of Health decided to identify Specialized Obesity Centers (CSO) in each region via the Regional Health Agencies: 37 specialized obesity centers were then created. In 2025, 5 new CSOs were created (2 in Picardy, 1 in Corsica, 1 in Brittany and one in Guyana), bringing their number to 42.
To go further:
Overweight and obesity: risk factors and prevention policies in France and around the world – Drees files.
