Key Points
Î More than 78 million adults in the United States were obese in 2009-2010.
Obesity raises the risk of morbidity from hypertension, dyslipidemia, type
2 diabetes mellitus (diabetes), coronary heart disease, stroke, gallbladder
disease, osteoarthritis, sleep apnea and respiratory problems, and some
cancers. Obesity is also associated with increased risk in all-cause and
cardiovascular disease (CVD) mortality.
Î Overweight is defined as a body mass index (BMI) of 25-29.9 kg/m
2
and
obesity as a BMI of ≥30 kg/m
2
. Current estimates are that 69% of adults are
either overweight or obese with approximately 35% obese.
Î It has been reported that, compared with normal weight individuals, obese
patients incur 46% increased inpatient costs, 27% more physician visits
and outpatient costs, and 80% increased spending on prescription drugs.
The medical care costs of obesity in the United States in 2008 totaled about
$147 billion.
Comprehensive Lifestyle Intervention
(for every patient who needs to lose weight)
Elements of High Intensity Comprehensive Lifestyle Intervention
Î Lower calorie diet
Î Increased physical activity
Î Behavioral strategies to achieve diet and activity goals
• Delivered on site by a trained interventionist
a
• 14 or more sessions in the first 6 months
• Continued follow-up for 1 year
a
Trained interventionist: In the studies reviewed, trained interventionists included mostly health professionals
(e.g., registered dietitians, psychologists, exercise specialists, health counselors, or professionals in training )
who adhered to formal protocols in weight management. In a few cases, lay persons were used as trained
interventionists; they received instruction in weight management protocols (designed by health professionals)
in programs that have been validated in high-quality trials published in peer-reviewed journals.
