Treatment
11
Lifestyle and Behavioral Therapy
➤ 2.1: In individuals at metabolic risk, ES recommends that lifestyle
modification be first-line therapy. (1|⊕⊕⊕⊕)
Technical Remark:
▶ The writing committee believes that primary care providers, endocrinologists,
geriatricians and cardiologists should initiate discussions about the importance of
adopting a healthy lifestyle with all individuals at metabolic risk. These and other
relevant providers should encourage individuals to join comprehensive programs
led by trained health professionals which support the adoption of healthy lifestyles,
including diet and physical activity, aiming for moderate but sustained weight loss.
➤ 2.2: For individuals at metabolic risk with excess weight (defined by
body mass index and/or waist circumference), ES recommends that
comprehensive programs to support the adoption of a healthy lifestyle
should aim to achieve a weight loss of ≥5% of initial body weight over the
first year. (1|⊕⊕⊕⊕)
Technical Remark:
▶ Maintenance of weight loss by adoption of sustainable healthy behaviors should
be encouraged with continuing support of primary providers and/or extended
programs.
➤ 2.3: In individuals at metabolic risk, ES recommends prescribing a
cardiovascular-healthy diet. (1|⊕⊕⊕
)
Technical Remarks:
▶ Providers can offer dietary recommendations based on common components of
healthy cardiovascular dietary patterns to all individuals at metabolic risk.
▶ Specific dietary changes according to individual risk profiles could be supported
with the help of a nutrition specialist in addition to the primary care provider.
➤ 2.4: In individuals at metabolic risk, ES recommends prescribing daily
physical activity, such as brisk walking, and reduction in sedentary time.
(1|⊕⊕⊕
)
Technical Remark:
▶ Providers should encourage all individuals at metabolic risk to adopt an active
lifestyle by walking and reducing the amount of time in sedentary activities.
Structured activity programs may be added with the help of an exercise specialist
for appropriate individuals.
