USPSTF: Behavior-Based Weight Loss Interventions Associated with Weight Loss and Lower Risk of Diabetes Interview with:

Chyke Doubeni, M.D., M.P.H.  Harrison McCrea Dickson, M.D. and Clifford C. Baker, M.D. Presidential Professor Associate Professor of Epidemiology  Senior scholar, Center for Clinical Epidemiology and Biostatistics  University of Pennsylvania School of Medicine

Dr. Doubeni

Chyke Doubeni, M.D., M.P.H.
Harrison McCrea Dickson, M.D. and Clifford C. Baker, M.D. Presidential Professor
Associate Professor of Epidemiology
Senior scholar, Center for Clinical Epidemiology and Biostatistics
University of Pennsylvania School of Medicine What is the background for this study? What are the main findings?

Response: Obesity is an important public health issue that affects nearly 4 in 10 American adults. It increases the risk for many chronic health conditions as well as premature death from diabetes, coronary heart disease, various types of cancer, and other conditions. As such, it was important for the U.S. Preventive Services Task Force to review the current evidence and update the recommendation on this topic.

Based on a review of the most recent studies, we found that intensive, multicomponent behavioral interventions are safe and effective. They can help people lose weight, maintain their weight loss, and reduce the risk of obesity-related conditions such as diabetes in people with high blood sugar. Therefore, the Task Force is recommending that clinicians offer or refer adults with a body mass index, or BMI, of 30 kg/m2 or higher to these behavioral interventions. What should readers take away from your report?

Response: There are many evidence-based programs that can help people lose weight, and clinicians should discuss with their patients which one is right for them. The effective intensive, multicomponent interventions are programs that require frequent, regular, ongoing interactions or contacts over several months or years to address the many related factors that lead to obesity. The components of the interventions typically include counseling and support on healthy eating and increased physical activity along with setting achievable goals, and providing tools for self-monitoring. The interventions can be delivered in classroom-style group sessions, individual face-to-face counseling, or technology-based programs using a smartphone app. These interventions have proven to help people get to a healthy weight status and lower their risk of illnesses that are associated with obesity. What recommendations do you have for future research as a result of this work?

Response: There are a number of important areas in which the Task Force is calling for more research on this topic. We need studies to look at the effects of interventions on long-term weight status and health outcomes, particularly in groups like older adults and racial minorities. We also need more research in primary care settings on whether intensive multicomponent behavioral interventions reduce health risks in people who are overweight (BMI of 25 to 29.9kg/m2). We would also like to see more studies on genetic and environmental factors that may make behavioral interventions more or less effective in individuals. Given the many components of these interventions and their many modes of delivery, we need evidence to better understand which components or approaches of the interventions are most effective and for what types of individuals. Lastly, evidence is needed on whether or not interventions that focus on weight loss and support of people living with obesity lead to meaningful improvements in quality of life and patient-centered outcomes. Is there anything else you would like to add?

Response: The prevalence of obesity among American adults continues to rise. Clinicians can really help their patients with obesity by screening for and documenting the presence of obesity in their patients and offering or referring those with obesity to intensive, multicomponent behavioral interventions. There are many intervention options to choose from. Therefore, clinicians should discuss the available options with their patients to determine which one is best for each specific patient based on their preference and the available resources. Anyone who is concerned about their weight status and body mass index or obesity-related illnesses should talk to their doctor.


LeBlanc ES, Patnode CD, Webber EM, Redmond N, Rushkin M, O’Connor EA. Behavioral and Pharmacotherapy Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in AdultsUpdated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2018;320(11):1172–1191. doi:10.1001/jama.2018.7777

Sep 20, 2018 @ 4:28 pm 

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