For preventing health problems in people who are obese, intensive behavioral interventions focused on improving eating and exercise habits may be the best prescription, U.S. doctors advise.
Obese adults should receive counseling and other programs to help them adopt and stick to a healthy diet, maintain or increase physical activity and understand and address obstacles to weight loss, according to recommendations just issued by the U.S. Preventive Services Task Force (USPSTF).
This advice isn’t new. The Task Force made similar recommendations in 2012. But recent research confirms that behavioral approaches really can help people achieve meaningful weight loss and better health.
The recommendations re-emphasize that health care providers can really help adults with obesity by offering or referring them to interventions such as group counseling, one-on-one counseling in-person, and online resources.
Obesity is linked to many chronic health problems including type 2 diabetes, heart disease, joint damage, mobility limitations and certain cancers. People with obesity also have a greater risk of early death than individuals with a healthy weight.
Weight loss interventions tested in recent studies varied widely in how they were provided and in the frequency and duration of treatment sessions. Some interventions involved group counseling while others used one-on-one sessions; certain programs were led by nutritionists while others relied on primary care providers. However, specific weight loss messages and behavior change techniques were consistent across the trials.
Most of the interventions involved group, individual, and technology-based education and counseling that was designed to help participants achieve a five percent or greater weight loss through a combination of dietary changes (including specific caloric goals) and a gradual increase in physical activity (promoting at least 150 minutes of moderate-intensity activity per week).
While these efforts can translate into meaningful weight loss for some people, it’s not a one-size-fits all fix.
Some individuals with obesity don’t respond to even the best behavioral treatment with enough weight loss to improve health, say experts. Obesity medications added to behavioral treatment can be helpful for some patients.
There’s less evidence that weight-loss drugs work, however, and they can have dangerous side effects, the Task Force notes in its recommendation statement.
Lifestyle intervention through diet, exercise and behavioral modifications are the first-line cornerstones of obesity management approaches.
Experts content that while weight loss medications and bariatric surgery are additional strategies which can be combined with behavioral intervention to reduce food intake and increase physical activity, these are options for patients who have been unable to successfully lose weight or maintain a goal weight and/or are exhibiting health problems related to their weight.
Source: JAMA, online September 18, 2018.
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