2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults

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Most cited references 130

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Annual medical spending attributable to obesity: payer-and service-specific estimates.

Eric Finkelstein, Justin G Trogdon, Joel W Cohen … (2009)

In 1998 the medical costs of obesity were estimated to be as high as $78.5 billion, with roughly half financed by Medicare and Medicaid. This analysis presents updated estimates of the costs of obesity for the United States across payers (Medicare, Medicaid, and private insurers), in separate categories for inpatient, non-inpatient, and prescription drug spending. We found that the increased prevalence of obesity is responsible for almost $40 billion of increased medical spending through 2006, including $7 billion in Medicare prescription drug costs. We estimate that the medical costs of obesity could have risen to $147 billion per year by 2008.

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Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial.

Xavier Pi-Sunyer, George Blackburn, Frederick Brancati … (2007)

The effectiveness of intentional weight loss in reducing cardiovascular disease (CVD) events in type 2 diabetes is unknown. This report describes 1-year changes in CVD risk factors in a trial designed to examine the long-term effects of an intensive lifestyle intervention on the incidence of major CVD events. This study consisted of a multicentered, randomized, controlled trial of 5,145 individuals with type 2 diabetes, aged 45-74 years, with BMI >25 kg/m2 (>27 kg/m2 if taking insulin). An intensive lifestyle intervention (ILI) involving group and individual meetings to achieve and maintain weight loss through decreased caloric intake and increased physical activity was compared with a diabetes support and education (DSE) condition. Participants assigned to ILI lost an average 8.6% of their initial weight vs. 0.7% in DSE group (P < 0.001). Mean fitness increased in ILI by 20.9 vs. 5.8% in DSE (P < 0.001). A greater proportion of ILI participants had reductions in diabetes, hypertension, and lipid-lowering medicines. Mean A1C dropped from 7.3 to 6.6% in ILI (P < 0.001) vs. from 7.3 to 7.2% in DSE. Systolic and diastolic pressure, triglycerides, HDL cholesterol, and urine albumin-to-creatinine ratio improved significantly more in ILI than DSE participants (all P < 0.01). At 1 year, ILI resulted in clinically significant weight loss in people with type 2 diabetes. This was associated with improved diabetes control and CVD risk factors and reduced medicine use in ILI versus DSE. Continued intervention and follow-up will determine whether these changes are maintained and will reduce CVD risk.

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The Look AHEAD study: a description of the lifestyle intervention and the evidence supporting it.

Thomas A. Wadden, Delia West, Linda M Delahanty … (2006)

The Look AHEAD (Action for Health in Diabetes) study is a multicenter, randomized controlled trial designed to determine whether intentional weight loss reduces cardiovascular morbidity and mortality in overweight individuals with type 2 diabetes. The study began in 2001 and is scheduled to conclude in 2012. A total of 5145 participants have been randomly assigned to a lifestyle intervention or to an enhanced usual care condition (i.e., diabetes support and education). This article describes the lifestyle intervention and the empirical evidence to support it. The two principal intervention goals are to induce a mean loss >or = 7% of initial weight and to increase participants' moderately intense physical activity to > or =175 min/wk. For the first 6 months, participants attend one individual and three group sessions per month and are encouraged to replace two meals and one snack a day with liquid shakes and meal bars. From months 7 to 12, they attend one individual and two group meetings per month and continue to replace one meal per day (which is recommended for the study's duration). Starting at month 7, more intensive behavioral interventions and weight loss medication are available from a toolbox, designed to help participants with limited weight loss. In Years 2 to 4, treatment is provided mainly on an individual basis and includes at least one on-site visit per month and a second contact by telephone, mail, or e-mail. After Year 4, participants are offered monthly individual visits. The intervention is delivered by a multidisciplinary team that includes medical staff who monitor participants at risk of hypoglycemic episodes.

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Michael D. Jensen: Role: Co-Chair

Donna H. Ryan: Role: Co-Chair

Journal

Journal ID (nlm-ta): Circulation

Journal ID (iso-abbrev): Circulation

Journal ID (publisher-id): CIR

Title: Circulation

Publisher: Lippincott Williams & Wilkins

ISSN (Print): 0009-7322

ISSN (Electronic): 1524-4539

Publication date (Print): 24 June 2014

Publication date (Electronic): 24 June 2014

Volume: 129

Issue: 25 Suppl 2

Pages: S102-S138

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Accession ID: 00007

DOI: 10.1161/01.cir.0000437739.71477.ee

PMC ID: 4097399

PubMed ID: 24222017

SO-VID: 8e30b253-8dff-4e47-bde0-2c36071190a8

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Circulation is published on behalf of the American Heart Association, Inc., by Wolters Kluwer; the Journal of the American College of Cardiology is published on behalf of the American College of Cardiology Foundation by Elsevier Inc.; Obesity is published on behalf of The Obesity Society by John Wiley and Sons Inc. This is an open access article under the terms of the Creative Commons Attribution Non-Commercial-NoDervis License, which permits use, distribution, and reproduction in any medium, provided that the Contribution is properly cited, the use is noncommercial, and no modifications or adaptations are made.

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Keywords: aha scientific statements,bariatric surgery,behavior therapy,blood pressure,body mass index,diabetes mellitus,diet,dyslipidemia,lifestyle,waist circumference,weight loss

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Keywords: aha scientific statements, bariatric surgery, behavior therapy, blood pressure, body mass index, diabetes mellitus, diet, dyslipidemia, lifestyle, waist circumference, weight loss

2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults : A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society

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Karger: Nutrition and Dietetics

Most cited references 130

Annual medical spending attributable to obesity: payer-and service-specific estimates.

Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial.

The Look AHEAD study: a description of the lifestyle intervention and the evidence supporting it.

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