Figure 2. Treatment Algorithm—The Chronic Disease
Management Model for Primary Care of Patients
with Overweight and Obesity
a
Assess and treat CVD risk
factors and obesity-related
comorbidities
BMI ≥25
Assess weight and lifestyle
histories
YES
YES, ready
Assess need to lose weight: BMI
≥30 or BMI 25-29.9 with risk
factor(s)
Assess readiness to make lifestyle
changes to achieve weight loss
Insufficient risk
NO
Not yet ready
NO
Comprehensive lifestyle intervention alone or
with adjunctive therapies (BMI ≥30
or ≥27 with comorbidity)
b
Determine weight loss and health
goals and intervention strategies
High intensity
comprehensive
lifestyle intervention
Alternative
delivery of lifestyle
intervention
Weight loss ≥5% and
sufficient improvement
in health targets
BMI ≥40 or BMI ≥35 with
comorbidity. Offer referral to an
experienced bariatric surgeon for
consultation and evaluation as an
adjunct to comprehensive lifestyle
intervention
BMI ≥30 or BMI ≥27 with
comorbidity—option for
adding pharmacotherapy as
an adjunct to comprehensive
lifestyle intervention
b
YES