The U.S. Preventive Services Task Force (USPSTF) last month released a final recommendation statement and evidence summary on behavioral weight loss interventions to prevent obesity-related morbidity and mortality in adults. Based on its review of the evidence, the USPSTF recommends that clinicians offer or refer adults with a body mass index (BMI) of 30 kg/m2 or higher to intensive, multicomponent behavioral interventions.
In their recommendation statement, which appeared in the Journal of the American Medical Association, the USPSTF point out that more than 35% of men and 40% of women in the United States are obese and that obesity is associated with health problems. “Obesity is also associated with an increased risk for death, particularly among adults younger than 65 years,” the authors write. “The leading causes of death among adults with obesity include ischemic heart disease, type 2 diabetes, respiratory diseases, and cancer (e.g., liver, kidney, breast, endometrial, prostate, and colon cancer).”
The USPSTF reviewed evidence on behavioral and pharmacotherapy interventions for weight loss that can be provided in a primary care setting, so weight loss surgery and nonsurgical weight loss devices were not included.
“The Task Force found that intensive, multicomponent behavioral programs are safe and effective, can help patients lose and maintain weight loss, and reduce risk of diabetes in people with elevated glucose levels,” says Task Force member Chyke A. Doubeni, MD, MPH. “There are many programs available, and one method or type of program isn’t necessarily right for everyone. We encourage people to talk to their clinician about what might work best for them.”
Effective intensive behavioral interventions may include use of group sessions (at least 12 sessions or more in the first year), help people make healthy eating choices, encourage increased physical activity and goal setting, and help people monitor their weight.
“Intensive, multicomponent behavioral interventions combine interventions such as counseling on nutrition and increased physical activity,” says Task Force vice chair Alex Krist, MD, MPH. “They can be conducted in group or classroom-style sessions that are led by a moderator, use face-to-face counseling, or use technology-based interventions like smartphone applications and social networks.”
Based on their findings, the authors conclude: “The USPSTF recommends that clinicians offer or refer adults with a body mass index of 30 or higher to intensive, multicomponent behavioral interventions.”
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