Primary Care Interventions for Obesity: Review of the Evidence.

Abstract

This review describes the results of randomized controlled trials that have evaluated the efficacy of behavioral interventions for obesity in primary care settings. Most studies have found that high-intensity behavioral counseling (providing 12 or more sessions per year, as defined by the US Preventative Services Task Force), when delivered in-person, by phone, or electronically, produced clinically meaningful weight loss (4 to 7kg). Low- to moderate-intensity behavioral counseling and counseling that did not include behavioral strategies (e.g., motivational interviewing) produced modest losses of 1 to 2kg. The addition of weight loss medication increased mean losses relative to behavioral treatment alone. Consistent with national guidelines, the largest weight losses were achieved with high-intensity counseling, either alone or in combination with obesity pharmacotherapy. Primary care providers can support their patients by inviting them to discuss their weight concerns and referring interested individuals to appropriate interventions.