Insights · Guidelines & Compliance

HAS and GCC-CSO recommendations on adult obesity: how Boli Care complies

Care pathways can only evolve with confidence if they rely on tools that respect the recommendations of the country’s learned societies and health authorities. That is why, from day one, we have based the design and development of the Boli Care platform on the recommendations of the French National Authority for Health (HAS) and, since their publication in 2025, on the more specific recommendations of the GCC-CSO.

By Boli Care 14 min read Published 5 October 2026

Our approach, features and patient content build on the recommendations of these texts. As a healthcare professional, you can therefore offer Boli to your patients with confidence: the platform was designed to fit current recommendations, and it leaves every decision that belongs to the clinician with the clinician.

Alignment, not endorsement

This alignment is Boli Care’s own initiative. It is in no way a sign of support, validation or recommendation from the HAS or the GCC-CSO. These organisations remain fully independent, as do the people who make up their boards, working groups and teams. Boli Care has no conflict of interest with these organisations or with the people who sit on them.

1. Three reference texts

The HAS good practice guideline (2022)

Validated by the HAS Board on 2 June 2022 and developed with the French Federation of Nutrition, the guideline “Adult obesity: second and third-level care. Part I: medical care” contains 42 recommendations, almost all based on expert agreement¹.

It first organises care into three levels: the general practitioner coordinates level 1, the nutrition physician level 2, and specialised obesity centres (CSO) and university hospitals level 3. Grading relies on seven parameters (BMI, medical impact, functional impact, psychological dimension, aetiology, eating behaviour, weight trajectory), not on BMI alone, through shared decision-making¹.

It then details the assessment to offer: screening for complications, systematic search for sleep disorders, precise assessment of eating behaviour (binge eating disorder, night eating syndrome, SCOFF questionnaire), psychological and social dimensions, physical activity and quality of life¹.

On lifestyle changes, it states that the goal is not limited to weight, that any reduction in intake should be moderate and personalised, that unbalanced or very restrictive diets are advised against, and that the educational approach must be at the heart of all care. It sets physical activity targets (150 to 300 minutes of moderate activity a week and at least two days of muscle strengthening, reached gradually) and highlights the value of cognitive-behavioural and emotion-focused therapies and mindfulness¹.

Finally, the decision to start a medication belongs to levels 2 and 3, after well-conducted nutritional care has failed, or straight away in some severe situations¹.

The HAS care pathway guide (2023, updated 2024)

The guide on overweight and obesity in adults, published in 2023 and updated in 2024, organises the pathway around 20 key messages²:

Screen for overweight and obesity throughout life, by measuring BMI and waist circumference.
Co-build a personalised care plan from diagnosis, based on a multidimensional, multiprofessional assessment: screening for eating disorders, psychological difficulties and social vulnerability, preventing stigma, involving patient associations.
Grade care according to three levels of complexity (non-complex, complex, very complex), with therapeutic education from diagnosis, coordination time and follow-up over several years, for life in complex situations. Medical follow-up is at least monthly at first and reassessed at 6-12 months.
Support people before and after bariatric surgery, and pay attention to specific populations.

The guide states that weight loss is not a priority in non-complex situations, and that stabilising weight is already a success. It also frames tools: self-monitoring (step counting, food diaries, mobile health) should be supervised by a professional and avoided in restrictive eating disorders or excessive exercise; telecare can be combined with in-person care; self-learning tools complement therapeutic education without replacing it².

The GCC-CSO position statement (2025)

The coordination group of the French specialised obesity centres (GCC-CSO) published in 2025 a position statement on anti-obesity medications (liraglutide, semaglutide, tirzepatide) in adults. Written from May to September 2025 by twelve experts coordinated by Prof. Judith Aron-Wisnewsky and Prof. Emmanuel Disse, the text was reviewed and approved by fifteen organisations (learned societies, patient associations and the GCC-CSO itself). It brings together 45 opinions from the working group, most of them graded, and 21 practical information boxes³.

Its main messages:

Place of treatment. It is not first-line: it is a second-line option, after six months of lifestyle care that did not reach personalised goals, through shared decision-making, with support from a nutrition professional.
Follow-up. Weight is followed at 3, 6 and 12 months; overly rapid loss (10% or more at 3 months, 20% or more at 6 months) is a warning sign prompting a search for undernutrition or a restrictive eating disorder. Treatment is long-term.
Tolerance. Gastrointestinal side effects, common during dose escalation, should be proactively screened for and managed, first with dietary adjustments; escalation adapts to tolerance.
Nutrition and muscle. At least two meals a day, at least 1.5 L of fluids, a protein intake of at least 60 g a day, strength combined with endurance training, and follow-up of muscle strength, systematic in at-risk patients: look beyond the scale.
Mental health and eating disorders. Mental health is considered before and during treatment; binge eating disorder is managed first; patients at risk of restrictive disorders are identified and closely followed.
Specific situations. Information on symptoms that require medical attention, pregnancy and contraception, bariatric surgery.

2. Boli Care, designed within this framework

These three texts converge on holistic care that goes beyond weight, is built with the patient, continues over time and is coordinated between professionals. This is exactly the role of Boli Care.

The app supports patients every day: regular check-ins on tolerance, eating behaviour, mood, stress and sleep; follow-up of treatment, weight, activity and protein; and educational content validated by a nutrition physician. The clinician interface turns these data into a summary that informs the consultation and helps organise hybrid care pathways.

Boli also respects the limits set by these texts. It makes no diagnosis, does not prescribe, calculates no dose, prescribes no diet and shows no calorie target. It requires no real-time monitoring and does not replace the consultation. Every decision stays with the clinician.

3. The ten main recommendations

01A multidimensional assessment

The HAS calls for an assessment that goes beyond BMI: eating behaviour, psychological and social impact, physical activity, quality of life and complications, in a multiprofessional approach¹^,².

In Boli. The inclusion questionnaire, completed by the patient at registration and available to the clinician before the consultation, covers daily life, health and history, weight history and the care plan. Clinicians see it organised by clinical dimension.

02Screening for eating disorders

The HAS asks clinicians to look for binge eating disorder and night eating syndrome¹ and to screen for eating disorders². The GCC-CSO recommends identifying patients at risk of restrictive disorders before a medication³.

In Boli. Screening questions at inclusion and weekly items (loss of control, snacking, night eating, restriction, compensation) are shown to the clinician. Boli makes no diagnosis and sends no message to the patient about these answers.

03Mental health, sleep and stress

The HAS calls for a systematic assessment of psychological difficulties and a search for sleep disorders¹^,². The GCC-CSO asks that mental health be considered before and during treatment³.

In Boli. Mood, stress and sleep are followed weekly and shown to the clinician over time. CBT-based programmes are being rolled out.

04A goal beyond weight, without restrictive diets

The goal of care includes complications, quality of life and mobility. Any reduction in intake should be moderate and personalised, and very restrictive diets are advised against¹^,².

In Boli. No diet is prescribed and no calorie target is shown. Feelings logged at each meal (hunger, difficulty stopping, guilt) help work on internal signals, and follow-up covers far more than weight.

05Nutrition on treatment

The GCC-CSO recommends at least two meals a day, at least 1.5 L of fluids and a protein intake of at least 60 g a day³.

In Boli. The meal journal and protein tracking (default target 60 g, adjustable by the clinician) come with validated content on protein, hydration and eating on treatment.

06Physical activity and preserving muscle mass

The HAS sets physical activity targets, including muscle strengthening¹. The GCC-CSO recommends preserving muscle and following muscle strength (chair stand, grip strength), systematically in at-risk patients and ideally in all, looking beyond the scale³.

In Boli. Steps are tracked, with a goal set by the clinician; the chair-stand test is offered in the app and grip strength is entered by the clinician. Content covers muscle strengthening, and adapted physical activity programmes are being rolled out.

07Tolerance and side effects

Gastrointestinal side effects should be proactively screened for and managed, first with dietary adjustments, and dose escalation adapts to tolerance³.

In Boli. Patients report their side effects weekly, graded by their impact. Clinicians see them in an evolution grid, next to dose steps, and patients have practical advice sheets per symptom.

08Long-term treatment follow-up

Weight is followed at 3, 6 and 12 months, overly rapid loss is a warning sign, and patients are told from the start that treatment is long-term³.

In Boli. The weight and dose-step trajectory, taken or missed doses and adherence are followed. These data are shown to the clinician, who interprets the thresholds described by the GCC-CSO: Boli produces no automatic alert.

09Education at the heart of the pathway

The educational approach is at the heart of all care and starts from diagnosis¹^,². Self-learning tools complement it without replacing it².

In Boli. An educational programme and practical sheets, validated by a nutrition physician, support patients and complement the therapeutic education delivered by clinicians, without replacing it.

10Coordinated, long-term follow-up

The HAS guide calls for coordination time, information sharing between professionals and follow-up over several years, for life in complex situations. It also states that self-monitoring should be supervised by a professional².

In Boli. A multiprofessional care team can follow each patient, with a longitudinal summary and a PDF export. Clinicians can turn self-monitoring off for patients who need it. Dietitian-patient messaging is being rolled out.

4. Detailed table: 33 recommendations

The table below lists, theme by theme, the main recommendations of these three texts, with their exact source (recommendation, key message or opinion number) and how Boli takes them into account.

Detailed table: 33 HAS and GCC-CSO recommendations and how Boli Care takes them into account
N°	Recommendation	Source	In Boli
Assessment and screening
01	Grade care on several parameters (not on BMI alone), through shared medical decision-making.	HAS 2022, R.1	RespectedBoli does not grade care or refer patients: it gives the clinician data on several dimensions.
02	Measure BMI and waist circumference, and follow their trend.	HAS guide, message 1	Built inWeight and waist journal (manual entry or sync), with the history since inclusion visible to the clinician.
03	Rely on a multidimensional, multiprofessional assessment.	HAS guide, message 2 HAS 2022, R.1, R.28 (Table 3)	Built inSix-chapter inclusion questionnaire (identity, daily life, health, family history, weight history, goals and care plan), shown to the clinician by clinical dimension.
04	Pay attention to quality of life, possibly with a questionnaire.	HAS 2022, R.21	Built inQuality-of-life scale at inclusion, then every month.
05	Systematically look for sleep disorders with simple questions.	HAS 2022, R.7	Built inSleep questionnaire at inclusion and a sleep scale in the weekly check-in.
06	Assess eating behaviour, notably binge eating disorder and night eating syndrome; screen for eating disorders.	HAS 2022, R.23 HAS guide, message 3	Built inScreening questions at inclusion and weekly items (loss of control, snacking, night eating, restriction, compensation), shown to the clinician, with no diagnosis.
07	Identify, by interview or questionnaire, patients at risk of restrictive eating disorders before a medication.	GCC-CSO, opinion 33	Built inSelf-reported history (anorexia, bulimia) visible to the clinician only; no message is shown to the patient.
08	Assess and support early psychological difficulties, psychiatric disorders and social vulnerability.	HAS guide, message 4 HAS 2022, R.24, R.25	Built inPsychiatric history and social context at inclusion, mood and stress followed weekly and shown to the clinician.
09	Recognise, prevent and support any stigma.	HAS guide, message 5	Built inStigma-free editorial rules (obesity is never a failure of willpower) and a question on felt stigma.
Goals and nutrition
10	The goal of care is not limited to weight.	HAS 2022, R.29 GCC-CSO, opinion 1, PI 4	RespectedFollow-up also covers tolerance, eating behaviour, mood, sleep, activity and quality of life.
11	Moderate, personalised reduction in intake; unbalanced or very restrictive diets advised against.	HAS 2022, R.32, R.34 HAS guide, guide p. 180	RespectedNo diet prescribed, no calorie target shown; editorial rule “never a restrictive diet”.
12	Eating guided by internal signals (hunger, fullness), taking the emotional component into account.	HAS 2022, R.33 GCC-CSO, opinion 14	Built inFeelings logged at each meal (hunger, difficulty stopping, guilt), items on emotional eating, dedicated content.
13	On treatment: keep at least 2 meals a day and drink at least 1.5 L a day.	GCC-CSO, opinion 14	Built inMeal journal, and validated advice on hydration and eating on treatment in the practical sheets.
14	Keep a protein intake of at least 60 g a day.	GCC-CSO, opinion 29	Built inDaily protein tracking, default target 60 g adjustable by the clinician; content on protein.
Physical activity and muscle mass
15	Reduce sedentary time and gradually reach activity targets, including muscle strengthening.	HAS 2022, R.36	Built inStep tracking and a clinician-set goal; content on muscle strengthening. Adapted physical activity programmes being rolled out.
16	Look beyond the scale: preserve muscle and follow muscle strength (chair stand, grip strength), systematically in at-risk patients and ideally in all.	GCC-CSO, opinion 28	Built inChair-stand test in the app, grip strength entered by the clinician, followed in the console.
17	Combine strength and endurance training for all patients on treatment.	GCC-CSO, opinion 29	Being rolled outAdapted physical activity programmes being rolled out; muscle-strengthening content available.
Self-monitoring and mental health
18	Self-monitoring should be supervised by a professional and avoided in restrictive eating disorders or excessive exercise.	HAS guide, guide §7.4	Built inData are read by the clinician, who can turn self-monitoring off for patients who need it.
19	Cognitive-behavioural and emotion-focused therapies and mindfulness help with disordered eating.	HAS 2022, R.39	Being rolled outCBT-based programmes being rolled out.
20	Consider mental health before and during medication; rapid weight loss can be destabilising.	GCC-CSO, opinion 25	Built inMood, stress and sleep followed weekly and shown to the clinician over time.
Anti-obesity medications
21	The decision to start a medication belongs to the prescriber (levels 2 and 3), shared with the patient, as second line.	HAS 2022, R.41, R.42 GCC-CSO, opinion 1	RespectedBoli neither prescribes nor calculates doses: the treatment is recorded and followed, and the decision stays with the prescriber.
22	Ensure support from a professional skilled in nutrition.	GCC-CSO, opinion 1	Built inDietitian or nutrition physician can join the patient’s care team; dietitian-patient messaging being rolled out.
23	Proactively screen for and manage gastrointestinal side effects, first with dietary adjustments.	GCC-CSO, opinion 13	Built inSide effects reported and graded weekly, an evolution grid for the clinician, practical advice sheets per symptom.
24	Adapt dose escalation to tolerance and inform the patient.	GCC-CSO, opinion 15	Built inDose steps and taken or missed doses followed in the app and console, next to tolerance; content on dose steps.
25	Follow weight at 3, 6 and 12 months; a loss of 10% or more at 3 months, or 20% or more at 6 months, is a warning sign.	GCC-CSO, opinion 2, opinion 26	RespectedThe weight and dose-step trajectory is shown to the clinician, who interprets the thresholds described by the GCC-CSO. Boli produces no automatic alert.
26	Tell the patient from the start that treatment is long-term.	GCC-CSO, opinion 4	Built inA part of the educational programme devoted to continuing treatment, and adherence follow-up.
27	Inform patients about symptoms that require prompt medical attention.	GCC-CSO, opinion 13, 16, 17, 19, 24	Built inPractical sheets per symptom (including abdominal pain and right-side pain), telling patients to talk to their doctor and, in an emergency, to call 15 (or 112).
28	No treatment during pregnancy; effective contraception and information for women of childbearing age.	GCC-CSO, opinion 34, opinion 36	Built inA “pregnancy and contraception” sheet and an information notice in the questionnaires.
Education, coordination and pathway
29	Offer therapeutic education from diagnosis; the educational approach is at the heart of care.	HAS guide, message 8 HAS 2022, R.37	Built inEducational programme and practical sheets validated by a nutrition physician, alongside support from clinicians.
30	Self-learning tools complement therapeutic education but do not replace it.	HAS guide, guide p. 62, p. 90	RespectedBoli content complements the therapeutic education delivered by clinicians, without replacing it.
31	Organise coordination and share information between the professionals of the pathway.	HAS guide, message 9	Built inMultiprofessional care team around the patient and PDF export of the summary.
32	Follow health regularly over several years, and for life in complex situations.	HAS guide, message 10	Built inRegular check-ins between consultations and a longitudinal summary for the clinician.
33	Telecare can be combined with in-person care, especially over the long term.	HAS guide, summary p. 14	RespectedBoli complements consultations without replacing them, and requires no real-time monitoring.

Built in feature or content available in Boli. Being rolled out feature being made available. Respected recommendation that belongs to the clinician: Boli respects it by not interfering with their decision.

Discover Boli Care: the patient summary and remote follow-up are presented on the Features page, and a demo can be arranged for your team.

See the features

References

Haute Autorité de santé, Fédération française de nutrition. Obésité de l’adulte : prise en charge de 2e et 3e niveaux. Partie I : prise en charge médicale. Good practice guideline, validated 2 June 2022. In French. has-sante.fr.
Haute Autorité de santé. Guide du parcours de soins : surpoids et obésité de l’adulte, and “20 messages clés” sheet. Updated February 2024, page updated 27 November 2024. In French. has-sante.fr.
Aron-Wisnewsky J, Tatulashvili S, Segrestin B, Bétry C, Achamrah N, Gatta-Chérifi B, Stenard F, Catheline JM, Dumotier A, Czernichow S, Ciangura C, Disse E. Prise de position du GCC-CSO sur les traitements médicamenteux de l’obésité (TMO) chez l’adulte et leur accompagnement en pratique. Médecine des Maladies Métaboliques 2025 (in press). In French. doi:10.1016/j.mmm.2025.10.003.