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    Experts Also Advise Counseling at-Risk Patients on Diet, Exercise

    June 25, 2012 -- Next time you see your doctor, be prepared to be weighed and measured -- and possibly referred to a weight loss program.

    In an updated recommendation, the U.S. Preventive Services Task Force (USPSTF), an independent panel of experts, is recommending that doctors screen all patients for obesity.

    The task force also recommended universal screening in its previous 2003 recommendation, but the new one goes a step farther, says David Grossman, MD, MPH, a USPSTF member who is also medical director for preventive care at Group Health Research Institute in Seattle.

    It recommends that doctors refer obese patients to intensive counseling for weight loss.

    "The doctor should help identify a suitable weight reduction program in their community that the doctor could refer them to," says Grossman.

    In a separate recommendation, the task force is also advising doctors to counsel certain other at-risk patients who aren't obese about better lifestyle choices.

    Both updated recommendations focus on nonsurgical interventions for excess weight, not weight loss surgery.

    More than 30% of U.S. adults are obese, the task force notes. It increases their risk of heart disease, diabetes, and other health problems.

    The updated recommendations are published online in the Annals of Internal Medicine.

    Obesity Screening Details

    Obesity screening can be done by calculating BMI, a measure of weight to height, or by measuring waist circumference, the task force says.

    BMIs of 30 or above are termed obese. A BMI of 25 to 29.9 is overweight. Normal BMIs are 18.5 to 24.9.

    Waist sizes above 35 inches for women and above 40 inches for men are linked with higher heart disease and diabetes risks.

    The task force does not specify how often obesity screening should be done.

    Many doctors do not screen for obesity now, Grossman says.

    "Just over 40% of adult patients in commercial HMOs had documented BMI measurements in 2009 and 2010," Grossman says, citing a national survey. In commercial PPO plans, only 12% did, he says.

    What Kind of Weight Loss Program?

    If referral to a weight loss program is needed, Grossman says it should be to an intensive program.

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