Adherence
High-intensity behavioral counseling delivered by trained interventionists (in person or via telephone) produces clinically meaningful weight loss (mean 5-6.6 kg at 6 months) in primary care settings, whereas counseling by primary care practitioners alone yields negligible loss (0.6-1.7 kg).
If you are obese and seeking weight loss in primary care, ask for a referral to a high-intensity behavioral program delivered by a trained specialist (like a dietitian or health coach) rather than relying solely on your doctor's brief advice. Look for programs that include a calorie deficit of 500 kcal/day, 150 minutes of weekly exercise, and regular check-ins (ideally 14 sessions over 6 months). This approach has been shown to produce significant, clinically meaningful weight loss (5-6 kg) compared to standard care.
Interventions that prescribed both reduced energy intake (eg, (-) 500 kcal/d) and increased physical activity (eg, (-)150 minutes a week of walking), with traditional behavioral therapy, generally produced larger weight loss than interventions without all 3 specific components. In the former trials, more treatment sessions, delivered in person or by telephone by trained interventionists, were associated with greater mean weight loss and likelihood of patients losing 5% or more of baseline weight.
Why this rating
Systematic review of 12 randomized controlled trials with good quality ratings, though heterogeneity exists in delivery methods.
Source
Behavioral Treatment of Obesity in Patients Encountered in Primary Care Settings
Thomas A. Wadden et al. · JAMA · 2014
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