Trial of Prevention and Reduction of Obesity Through Active Living in Clinical Settings

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Abstract
Obesity increases the risk of numerous chronic diseases, resulting in a decline in the quality and duration of life.1,2 Despite widespread awareness of the importance of reducing obesity and promoting healthy lifestyles, most primary care clinicians fail to counsel obese patients adequately.3 Commonly cited barriers include limited time, counseling expertise, and staff support and a lack of effective treatments.4,5 These limitations are reinforced by the recommendation that clinicians screen adults for obesity and offer intensive counseling and behavioral interventions for weight management.1,6 The US Preventive Services Task Force recommends intensive counseling (defined as >1 visit per month for 6 months) because evidence does not support the use of low- or moderate-intensity counseling (3-6 visits during 1-2 years) by primary care physicians alone as an effective strategy for achieving weight loss.6,7 The time and expense required for primary care practitioners to provide high-intensity behavioral counseling as recommended is unlikely given the absence of adequate reimbursement and the routine demands of office practice.

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