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Dietary strategies emphasizing reduced caloric intake, regardless of the nutrient composition, are important for weight loss.Behavioral interventions such as motivational interviewing and encouraging physical activity lead to additional weight loss when combined with dietary changes. IVEY, Psy D; and KATIE SEIKEL, DO, RD, Swedish Family Medicine Residency, University of Colorado School of Medicine, Littleton, Colorado Am Fam Physician. Obesity is a common condition that is associated with numerous medical problems such as cardiovascular disease, pulmonary disease, and diabetes mellitus.Primary care physicians have an important role in helping patients develop a successful weight loss plan to improve their overall health.For those with obesity-related comorbid conditions, patients should be considered for adjustable gastric banding or other bariatric surgical approaches if they have a body mass index of 30 to 39.9 kg per m.The most commonly performed procedures for weight loss are Roux-en-Y gastric bypass, sleeve gastrectomy, and adjustable gastric banding.Medications approved for long-term treatment of obesity include orlistat, lorcaserin, liraglutide, phentermine/topiramate, and naltrexone/bupropion.Physicians should consider referring patients for bariatric surgery if they have a body mass index of 40 kg per m or greater.

Bariatric surgery is the most effective intervention for weight loss in obese patients, and it leads to improvement in multiple obesity-related conditions, including remission of diabetes. adults were overweight or obese.1 Many common medical problems, such as diabetes mellitus, pulmonary disease, and cardiovascular disease, are related to obesity and can improve with weight loss.2 The management of obesity continues to evolve with the approval of new treatments.

Obesity is a pervasive problem confronting patients and their physicians. This review will provide answers to some of the common clinical questions that physicians encounter when managing obesity in the outpatient setting.

Medication regimens for concomitant medical problems should take into account the effect of specific agents on the patient's weight.

Persons with a body mass index of 30 kg per m or greater with comorbidities who do not succeed in losing weight with diet and activity modifications may consider medication to assist with weight loss.

Using a single dietary adjustment may produce weight loss similar to more complex plans.For example, encouraging a patient to increase dietary fiber intake produces comparable adherence and weight loss to encouraging compliance with the many goals of the American Heart Association diet.



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