Two thirds of the American population is overweight or obese. A recent study showed the medical cost of obesity for 2008 to be as high as $147 billion and also found that obesity leads to many other medical problems including diabetes, high blood pressure, heart disease and stroke.

Findings in a recent study published in the Journal of General Internal Medicine done by Adam Gilden Tsai, MD, assistant professor of medicine at the University of Colorado Denver’s School of Medicine and his colleague Thomas Wadden, MD, professor of psychology in psychiatry and director of the Center for Weight and Eating Disorders at the University of Pennsylvania showed that high-intensity interventions did often times lead to a 5 percent weight loss in obese or overweight patients.  Effective interventions included 1) twice monthly counseling with a dietitian, in combination with the use of meal replacements; or 2) approximately monthly visits with a primary care provider, combined with weight loss medication.

“Primary care providers normally have six to seven clinical items to address during a typical visit, including all the routine things we do such as cancer screening and health maintenance,” said Tsai, MD “Busy clinicians have difficulty finding time to do intensive weight loss counseling.  Unless the provider is able to prescribe medication and to see the patient on a monthly basis, it may be best to give a personalized recommendation for weight loss. The clinician can then steer a patient toward a program in which he or she can receive intensive counseling from someone with weight loss expertise, such as a dietitian or a behavioral psychologist.”

Tsai and Wadden reviewed studies of weight loss treatment delivered in primary care settings. Low-intensity and moderate-intensity interventions in which weight loss counseling was conducted by primary care providers did not usually lead to clinically important weight loss.

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