In an update to its 2003 recommendation statement on screening for obesity in adults, the United States Preventive Services Task Force recommends screening all adult patients for obesity. Screening includes measurement of height and weight to ascertain BMI, although measuring waist circumference also is an accepted method.
Patients with a BMI of 30 or higher should be offered or referred to intensive, multicomponent behavioral interventions such as group or individual weight-loss counseling sessions.
The Task Force found that weight-loss outcomes improved when interventions involved at least 12-26 sessions in the first year. Patients with weight-related health issues (high blood pressure, diabetes) saw weight loss and physiologic improvements when behavioral interventions were combined with orlistat or metformin, However, orlistat has been linked to rare, severe liver disease, and metformin has not been approved by the FDA for use as an obesity treatment. Because of safety concerns and insufficient evidence to determine maintenance of improvement after discontinuing drug treatment, the Task Force did not include use of pharmacological agents in the recommendation.
In its previous recommendation, the Task Force recommended interventions for overweight adults with a BMI of between 25 and 29.9. But the results of trials included in the evidence review did not allow the Task Force to determine definitively if interventions for individuals who were overweight but not obese would yield the benefits observed in obese individuals.
Source: American College of Physicians, USA