Obesity: Manage, Treat Like a Disease


Obesity should be managed and treated like a disease, according to a new cardiovascular prevention guideline released Nov. 12 by The American Heart Association and the American College of Cardiology.

Eat fewer calories, exercise more, change unhealthy behaviors

The finding asserts that the best strategy to lose weight and keep it off requires a three-pronged approach: Eat fewer calories than your body needs, exercise more and change unhealthy behaviors.

Patients are more likely to stay on track when guided by a trained professional in a healthcare setting. That’s why healthcare providers are now urged to actively help patients achieve and maintain a healthier body weight, said Frank Hu, M.D., Ph.D., a professor of nutrition and epidemiology at Harvard School of Public Health in Boston.

Hu is an American Heart Association volunteer who sat on a 27-member expert committee that wrote the new Guideline for the Management of Overweight and Obesity in Adults, from the American Heart Association, American College of Cardiology and The Obesity Society.

Treat obesity as a disease, not just a “lifestyle issue”

“Clinicians should not just think of obesity as a lifestyle issue. They should treat obesity as a disease,” Hu said. “Providing preventive care services such as obesity screening and behavioral counseling are critically important.”

Included in the new guideline is a first-of-its-kind roadmap to help patients lose weight and keep it off. It starts with finding out who would benefit from weight loss by calculating at least once a year every American’s body mass index, which is an indicator of obesity based on height and weight. Patients with a BMI of 30 or higher are considered obese and need treatment. In the U.S., nearly 78 million adults are obese.

Weight-loss helps reduce health risks more than previously thought

For the overweight, the new guidelines found that more people can reap rewards from weight loss than previously thought. In 1998, federal guidelines suggested that overweight people must have at least two risk factors for obesity-related health problems to benefit from weight loss. But the revised guidelines find weight-loss dividends for people that have even just one risk factor, such as elevated blood pressure or high triglycerides (blood fats).

“The key message here is that we know weight loss isn’t just about will power,” said Donna Ryan, M.D., co-chair of the committee that wrote the guideline and professor emeritus at Louisiana State University’s Pennington Biomedical Research Center in Baton Rouge. “It’s about behaviors around food and physical activity, and getting the help you need to change those behaviors.”

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