The U.S. Preventative Services Task Force recommends clinicians screen adults for obesity, as well as offer or refer patients with a BMI of 30 kg/m2 or higher to intensive, multicomponent behavioral interventions.
The U.S. Preventive Services Task Force (USPSTF) identified 58 trials of weight-loss interventions, including 38 involving behavioral interventions, 18 involving orlistat plus behavioral interventions and three involving metformin plus behavioral interventions. The benefits and harms of screening and primary-care feasible or referable nonsurgical weight-loss interventions from these trials were reviewed.
Obese adults can achieve an average weight loss of 8.8 lbs to 15.4 lbs, improved glucose tolerance and improved physiologic risk factors for cardiovascular disease with intensive, multicomponent behavioral interventions, according to the study results. However, inadequate direct evidence was found for the effectiveness of these interventions on long-term health outcomes, such as death, cardiovascular disease and hospitalizations.
Overall, the USPSTF found improved weight-loss outcomes with 12 to 26 intervention sessions in the first year. Pharmacologic agents combined with behavioral interventions results in weight loss and improvement in physiologic outcomes. Since intensive interventions may be impractical in many primary care settings, the USPSTF recommends physicians referring patients to community-based programs for these interventions.
For more information:
Moyer VA. Ann Intern Med. 2012;157.
Disclosure: The researchers had no relevant financial disclosures.
