1) Who should be screened for obesity ?
What should be done if it is found ?
What level of USPSTF recommendation is this ?
Shull Video - Obesity
1) All adults should be screened for obesity
2) If found offer counselling & behavioral interventions
3) Grade B recommendation
1) What are the criteria to refer a person with a BMI > 25 for a comprehensive lifestylle intervention ?
2) What are the characteristics of most effective comprehensive lifestyle interventions (6) ?
1) Who to refer to a comprehensive LS intervention:
a) BMI >= 25 w CV disease risk factors OR
b) BMI >= 30
2) Effective interventions:
Setting - in person, single or group
How - high intensity (>= 14 sessions in 6 mos)
Staff - trained interventionists or nutrition professionals
What - calorie restriction, increased physical activity, behavioral changes to facilitate lifestyle changes.
1) What is a reasonable weight loss goal for overweight or obese patient ?
2) What is the average weight loss in an intensive lifestyle intervention program ?
Shull Video - Obesity
1) Goal 5-10% of initial body weight
2) Avg weight loss w intensive lifestyle is ~ 8 kg (17 lbs) over 6 months
- often end up w BMI ~ 33 (with which a lot of patients are disappointed)
What are the criteria for:
a) Referral for bariatric surgery ?
b) Combination of pharmacotherapy w intensive lifestyle therapies
Shull Video - Obesity
1) Refer to bariatrics if:
a) BMI >= 40 OR
b) BMI >= 35 with >= one obesity assoc comorbidity
2) Add pharmacotherapy to LS if:
a) BMI > 27 w co-morbidities
b) BMI > 30