More assertive recommendations issued for overweight people

Experts published updates to existing recommendations for those at risk of developing cardiovascular disease, advising intensive behavior counseling for overweight and obese patients.

by John Tyburski

Copyright © Daily Digest News, KPR Media, LLC. All rights reserved.

First published at Daily Digest News on August 25, 2014

The evidence has been reviewed, and the results are in. Overweight and obese patients at high risk for developing cardiovascular disease can benefit from “intensive behavioral counseling” on making changes to diet and exercise regimens.

This week, the U.S. Preventive Services Task Force (USPSTF) updated its 2003 recommendation on dietary counseling for adults at risk for cardiovascular disease, or CVD. The USPSTF reviewed evidence on whether counseling-based interventions promoting healthy diet and physical activity have any positive or negative effects on self-reported behaviors and a number of health indicators. The findings and updated recommendations appear in the August 26 issue of Annals of Internal Medicine.

The updated recommendations specifically address the growing number of overweight and obese people with CVD risk factors. The risk factors include hypertension, high cholesterol, and metabolic syndrome, which is characterized by blood sugar levels above normal or near the level for diagnosing type II diabetes. The USPSTF found that intensive behavioral counseling can help these patients change their habits and lower their CVD risk.

“My message for patients would be that we have the ability by changing our behavior to modify our risk for heart disease and stroke and your doctors can help you do that,” Dr. Michael L. LeFevre, the chair of the Task Force, told Reuters Health in a phone interview.

LeFevre said that the updated recommendations are targeted more at health care professionals than at the patients.

“The most important thing that we can do right now is have you [the patient] lose some weight, be more active but just offering that advice and giving you a pamphlet, we don’t really find any evidence that that’s helpful,” LeFevre said, indicating the message he wants to give patients.

The USPSTF recommendations focus more on having doctors send their overweight and obese CVD candidates to multi-session behavioral counseling intended to effect changes in diet and lifestyle. Behavioral counseling works, according to the evidence reviewed by the Task Force.

“This crystallizes 25 years of research and a huge number of studies but I don’t think this is new or earth shattering information,” said Dr. Jennifer S. Lin of the Kaiser Permanente Center for Health Research in Portland Oregon. Lin was the lead author on the report.

The USPSTF was created in 1984 and serves as an independent, purely volunteer panel of experts in prevention and evidence-based medicine. The committee endeavors to improve the health of all Americans by making evidence-based recommendations on clinical preventive services.