Effectiveness of Early Detection and Intervention

Counseling and behavioral interventions produce small to modest degrees of weight loss sustained over at least 1 year (McTigue et al., 2003). High-intensity or more frequent counseling promotes greater weight loss than low-intensity counseling. Moderate intentional weight loss (5%-10% of body weight) decreases the severity of the comorbidities associated with obesity and may reduce mortality. Pharmacotherapy also promotes modest weight loss (3-5 kg); discontinuing the medication may lead to rapid regain. Obesity surgery has been performed on patients with a BMI greater than 40 or with obesity-related comorbidities and has achieved dramatic weight loss.

Potential harms associated with screening and treatment include the stigma of being labeled "obese" and the detrimental health effects from cycles of weight loss followed by regain. Medications may cause adverse effects, and their long-term safety is not well known. A patient undergoing surgery may have complications, and 25% require reoperation within 5 years (McTigue et al., 2003).

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