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Contempo Updates | Clinician's Corner

Weight Loss Counseling Revisited

Mary K. Serdula, MD, MPH; Laura Kettel Khan, PhD; William H. Dietz, MD, PhD
JAMA. 2003;289(14):1747-1750. doi:10.1001/jama.289.14.1747.
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Physicians and other health care professionals often perceive obesity treatment as labor intensive and unsuccessful. Currently, only 42% of obese adults report being advised to lose weight by their health care professional.1 Patients who do attempt to lose weight often arrange to do so through commercial or self-help programs independent of their physician.2 If treatment success is defined exclusively as attaining ideal weight after losing a large amount of weight during a short-term intervention, obesity treatment will almost certainly fail. However, small weight losses can reduce obesity-associated risk factors for chronic diseases such as diabetes and hypertension.3 Obesity must be recognized as a chronic condition for which no cure can reasonably be expected.4

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Figure. Evidence-Based Algorithm for the Treatment of Obesity
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BMI indicates body mass index, calculated as weight in kilograms divided by the square of height in meters. Figure based on information from National Institutes of Health3 and S. Yanovski and J. Yanovski.8 For risk factors, see "Assess Obesity Risk" in text.



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