(HealthDay News) — Clinicians should screen all adults for obesity; and, there is a small health benefit for initiating behavioral counseling interventions in a primary care setting for adults without cardiovascular disease (CVD) or its risk factors, according to two recommendation statements published online June 26 in the Annals of Internal Medicine.

Virginia A. Moyer, M.D., M.P.H., from Baylor College of Medicine in Houston, and colleagues on behalf of the U.S. Preventive Services Task Force (USPSTF), reviewed new evidence on the benefits and harms of screening and updated the 2003 recommendation statement on screening for obesity and overweight in adults. The USPSTF recommends that clinicians screen all adults for obesity. A grade B recommendation was given for clinicians to refer patients with a body mass index of 30 kg/m² or more to intensive, multicomponent behavioral interventions.

Moyer and colleagues also updated the 2002 and 2003 USPSTF recommendation statements on behavioral counseling to promote a healthful diet and physical activity. Evidence was reviewed on whether counseling interventions modified self-reported behaviors, intermediate physiologic outcomes, and cardiovascular morbidity and mortality for the general U.S. adult population without a known diagnosis of hypertension, diabetes, hyperlipidemia, or CVD. Existing evidence indicated that there was a limited health benefit of behavioral counseling in the primary care setting. Rather than include counseling for all adults, clinicians may prefer to selectively counsel patients.

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“The USPSTF concludes with moderate certainty that medium- or high-intensity behavioral counseling interventions in the primary care setting to promote a healthful diet and physical activity have a small net benefit in adult patients without CVD, hypertension, hyperlipidemia, or diabetes,” Moyer and colleagues write in the second study.

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