Diet, exercise, and the challenge of combating obesity in primary care

Obesity has reached epidemic proportions in the United States and in most industrialized nations. More than 60% of US adults are now overweight or obese, predisposing over 97 million Americans to a host of chronic lifestyle diseases, particularly cardiovascular disease. Despite the existence of explicit evidence-based consensus reports on the health risks of obesity and the health benefits of even moderate amounts of weight loss, many patients do not receive advice from their health care providers to lose weight or on how to do so effectively. Even modest physical activity and small incremental healthy dietary changes when incorporated into one's lifestyle have a positive effect on weight loss and promote the maintenance of favorable body weight and body composition changes with advancing age. This article describes elements of effective counseling and practical guidelines for developing a healthy lifestyle approach for overweight and obese individuals.