Behavioral intervention focus of preventative services task force recommendation for obesity-related mortality

The U.S. Preventive Services Task Force (USPSTF) released its updated recommendations on weight loss to prevent obesity-related mortality in adults, according to an announcement last week by the Office of Disease Prevention and Health Promotion.

The new guidelines recommend “clinicians offer or refer adults with a BMI of 30 or higher to intensive, multicomponent behavioral interventions that help people make healthy eating choices, encourage increased physical activity, and help people monitor their own weight.”

To support the recommendations, the USPSTF commissioned a systematic review including 122 randomized control trials and 2 observational studies. It found that behavior-based weight loss interventions had positive associations with weight loss and with lower risk of developing diabetes.

The review identified several characteristics of effective intensive multicomponent behavioral interventions. Those that were successful were designed to help participants achieve or maintain a weight loss of 5 percent or more through a combination of dietary changes and increased physical activity. Most lasted for one years, and the majority had 12 or more sessions in the first year. They focused on problem solving to identify barriers, self-monitoring of weight, peer support, and relapse prevention, and provided tools to support weight loss or weight loss maintenance, such as pedometers, food scales, or exercise videos.

 “Intensive, multicomponent behavioral interventions combine interventions such as counseling on nutrition and increased physical activity,” says Alex Krist, MD, MPH, task force chair, in a statement released by the agency. “They can be conducted in group or classroom-style sessions that are led by a moderator, use face-to-face counseling, or use technology-based interventions like smartphone applications and social networks.”

Weight management is a priority for agencies across the federal government, state governments, communities, and the health care sector, the task force says. Nearly 40 percent of U.S. adults have obesity, according to the U.S. Centers for Disease Control and Prevention, which increases their risk for serious diseases, including heart disease, type 2 diabetes, and many cancers. In addition, nearly 1 in 3 U.S. adults are overweight.

The new recommendation received a grade of B, meaning the USPSTF recommends the service and suggests that primary care clinicians offer or provide it.