USPSTF Guidelines Recommend Obesity Screening and Counseling

Intensive behavioral interventions are recommended for all obese adults, but lifestyle counseling for healthy adults in the primary care setting is not necessarily advised, according to a pair of guidelines from the U.S. Preventive Services Task Force published in the Annals of Internal Medicine.

In the first set of guidelines, the USPSTF recommends that clinicians screen all adults for obesity. For patients with a BMI of 30 or higher, clinicians should provide intensive, multicomponent behavioral interventions or refer patients to such a program (grade B recommendation). The task force found evidence that intensive interventions can improve glucose tolerance and other cardiovascular risk factors, which is a change from its 2003 recommendations.

In a second set of guidelines, the USPSTF does not recommend for or against counseling healthy adults — free of cardiovascular disease, hypertension, hyperlipidemia, or diabetes — about diet and physical activity (grade C recommendation). Benefits of such counseling are small to moderate, according to their review. Counseling may be offered on a case-by-case basis.