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Review: counselling, pharmacotherapy, and surgery help obese adults lose weight

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 Q In adults, is obesity screening and treatment effective?

Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ IM/Ambulatory care ★★★★★☆☆ Cardiology ★★★★★☆☆ Endocrine ★★★★☆☆☆ Geriatrics ★★★★★★☆


Embedded ImageData sources:

Medline, the Cochrane Library, and systematic reviews from the US, Canada, and the UK.

Embedded ImageStudy selection and assessment:

randomised controlled trials (RCTs) or systematic reviews of screening and treatment for obesity. Drug treatment studies had to have ⩾6 months of follow up; all other treatments had to have ⩾12 months of follow up. Study quality was assessed using the US Preventive Services Task Force criteria.

Embedded ImageOutcome:

weight loss.


No RCTs evaluated the efficacy of obesity screening. Counselling and behavioural interventions. 3 systematic reviews showed that behavioural interventions promoting exercise and/or dietary change achieved small weight reductions (US: 29 RCTs, mean weight change over controls −3.3 kg, range −8.8 to 1.9 at ⩾1 y) (UK: 24 RCTs, mean weight change over controls −3.0, range −10.6 to 1.4 at 12–60 mo) (Canada: 6 RCTs, mean weight change over controls −2.1, range −4.5 to −0.2 at 24–84 mo). Of …

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  • For correspondence: Dr K M McTigue, University of Pittsburgh, Pittsburgh, PA, USA.

  • Source of funding: Agency for Healthcare Research and Quality.