Consensus That Addressing Obesity Is Important
As a result of the increasingly compelling data on the growing prevalence of obesity, the adverse effects of obesity on health, and the costs of the condition, a broad consensus has emerged that evaluating patients for obesity should be an integral part of usual clinical care. One of the first groups to provide guidance on this topic was the National Heart, Lung, and Blood Institute (NHLBI) Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, which was first published in Obesity Research in 1998 (15). More recently, a comprehensive evaluation of the evidence for screening for obesity in adults was published by the US Preventive Services Task Force (USPSTF) (16) along with recommendations for clinical evaluation (17). This organization, which is relatively conservative and firmly evidence-based, felt that determining BMI in adult patients was justified and that there was fair evidence that high-intensity counseling produces modest, sustained weight loss. More recently, following the publication of the USPSTF report, the American College of Physicians (ACP), the professional organization that represents the field of internal medicine, published meta-analyses of pharmacotherapy (18) and surgical therapy (19) for obesity and took the position that it was reasonable to discuss these interventions with obese patients who had not reached a weight-loss goal through behavioral means alone (20). A large number of organizations have taken positions advocating more awareness of obesity as a health problem, encouraging screening for associated illnesses and a more aggressive approach to counseling patients about diet and physical activity. These include the American Heart Association (21), the American Academy of Pediatrics (22), the American Gastroenterological Association (23), the American College of Preventive Medicine (24), the American Diabetes Association (25), and the Surgeon General (26), to name just a few. It seems clear that addressing weight as a health issue with patients in primary and specialty care has been recognized as a legitimate even mainstream part of clinical care.
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