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Screening for and Management of Obesity and Overweight in Adults [Internet]

Screening for and Management of Obesity and Overweight in Adults [Internet]

Evidence Syntheses - Agency for Healthcare Research and Quality (US)

Version: October 2011

Discussion

We found no trials directly examining the benefit of screening for adult obesity. Six behavioral-based trials either screened consecutive patients in primary care practices,, or identified potentially eligible participants through medical records or disease registries and then invited them for further screening.,, All of these trials included fewer than 10 treatment sessions. Two of the five trials (both fair-quality) showed greater weight loss in intervention participants., No medication trials screened consecutive patients in primary care practices; however, three orlistat studies (one good- and two fair-quality) identified potentially eligible participants through medical records or disease registries and then invited them for screening., , These trials showed mixed but generally positive results. These trials suggest that weight loss programs can be effective in screen-detected patients, although it cannot be determined if screening affects the likelihood of success in weight loss (Table 18).

Introduction

This systematic evidence review examinereferences.rs the benefits and harms of screening adults for obesity and overweight. The U.S. Preventive Services Task Force (USPSTF) will use this review to update its previous 2003 recommendation on screening adults for obesity and overweight. This targeted systematic review addresses the benefits and harms of programs that screen for overweight and obesity in adults in primary care settings, and articulates the benefits and harms of primary care-feasible or –referable weight loss interventions (behavioral-based interventions and/or pharmacotherapy) for obese or overweight adults. Because the previous evidence report found good-quality evidence for using body mass index (BMI) to identify adults with increased risk of future morbidity and mortality, we did not systematically address reliable and valid clinical screening tests for obesity and overweight. As part of the “Screening Strategies” section, we briefly discuss whether waist-to-hip ratio (WHR), waist circumference, or other related measures of central adiposity have independent predictive value for future mortality and health risks compared with BMI measures only.

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