The U.S. Preventive Services Task Force called for every adult to be screened for obesity during checkups, including calculating body-mass index for each patient. Obese patients should be referred to intensive nutrition and fitness help, says the panel, instead of just being directed to go on a diet.
Two-thirds of American adults are either overweight or obese. About 17 percent of children and adolescents are obese and on track for diabetes, heart disease or other health problems.
Few doctors are trained to treat obesity, they're discouraged by yo-yo dieting but they don't know what to advise, says Dr. Glen Stream, president of the physicians' group. His Spokane, Wash., practice uses electronic medical records that automatically calculate BMI when a patient's height and weight is entered.
"Our American culture is always looking for an easy fix, a pill for every problem," Stream says. "The updated recommendation is important because it makes clear exactly what doctors should do to help."
In Monday's Annals of Internal Medicine, the task force concluded high-intensity behavioral interventions are the best non-surgical advice for the obese, citing insufficient evidence about lasting effects from weight-loss medications.
The task force says a good program:
- Includes 12 to 26 face-to-face meetings over a year, most in the first few months.
- Makes patients set realistic weight-loss goals. Losing just 5 percent of your initial weight -- 10 pounds for a 200-pound person -- can significantly improve health.
- Analyzes what blocks each patient from reaching those goals. Do they eat high-calorie comfort foods to deal with depression? Spend too much time at a desk job?
- Tailors ways to help people integrate physical activity into their daily routine.
- Requires self-monitoring, such as a food diary or a pedometer to track activity.
Last year, Medicare started paying primary care doctors for obesity screening and weight-loss counseling for seniors for a year, including weekly meetings for the first month.
By the numbers: A normal BMI is less than 25. Obesity begins at 30. In between is considered overweight. To calculate yours: National Institutes of Health Body Mass Calculator.
The Associated Press contributed to this report.