Task Force Backs Obesity Counseling

Article excerpt

A new recommendation from the U.S. Preventive Services Task Force may help physicians help their patients tackle obesity.

The task force now recommends that physicians screen their adult patients for obesity and offer intensive counseling, or refer obese patients to it, in order to promote weight loss. Intensive counseling includes two or more individual or group counseling sessions on diet and exercise monthly for at least 3 months (Ann. Intern. Med. 138[11]:930-49, 2003).

For Dr. Michael O. Fleming, it won't be hard to take these recommendations to heart. "I'm obese as well," said Dr. Fleming, president of the American Academy of Family Physicians. "I can put it in very personal terms when I talk to patients."

In conjunction with the AAFP's Americans in Motion initiative, Dr. Fleming has lost 19 pounds since this summer and uses a pedometer to count his steps. He recommends the device to patients as well.

The AAFP initiative asks family physicians to be role models for their patients by getting healthier.

It's important for "physicians to be able to walk the talk," and set a good example for their patients, said Dr. Fleming.

For too long, physicians have had the attitude of do what I say, not what I do, he said. "We have to take a leadership role."

Screening for obesity can be done one of two ways: either using body mass index (BMI) or centrally located body weight, the task force recommendations say. Patients with a BMI of 25-29.9 are considered overweight; those with a BMI above 30 are considered obese.

Centrally located body weight, which can be assessed by measuring waist circumference, can help screen for cardiovascular disease, the task force said. Men with waist circumferences of more than 40 inches and women with waist circumferences of more than 35 inches have an increased risk for cardiovascular disease. However, the recommendations say that these measurements may not be accurate for people with a BMI of more than 35.

The task force also concluded that there was insufficient evidence to recommend for or against the use of moderate- or low-intensity counseling--monthly or less frequent--to promote weight loss in obese adults. …