Task Force recommends obesity screening in adults

The U.S. Preventive Services Task Force has issued a recommendation on screening for obesity in adults.

To update its 2003 recommendation on screening for obesity and overweight in adults, the Task Force reviewed current evidence and identified new evidence that addressed previously noted gaps. Only nonsurgical interventions were considered. Unlike the 2003 recommendation, this update focuses on identifying obese adults (defined as having a body mass index ≥30 kg/m²) for intervention but not patients considered overweight (defined as having a body mass index of 25 to 29.9 kg/m²) because the separate effects of study interventions on overweight versus obesity could not be determined.

The Task Force recommended that clinicians screen for obesity in adults and that they should offer or refer those with a body mass index at or above 30 kg/m² to receive intensive, multicomponent behavioral interventions. This is a grade B recommendation (high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial). The Task Force noted that it found inadequate direct evidence about the effectiveness of behavioral interventions on long-term health outcomes such as death, cardiovascular disease and hospitalization.

The Task Force also published a separate recommendation on behavioral counseling to promote a healthy diet and physical activity to prevent cardiovascular disease in adults, noting that existing evidence shows a small benefit of such counseling in the primary care setting. “Clinicians may choose to selectively counsel patients rather than incorporate counseling in the care of all adults in the general population,” the Task Force concluded. This is a grade C recommendation (for most individuals without signs or symptoms there is likely to be only a small benefit from this service).

Both recommendation statements were published online June 26 by Annals of Internal Medicine.