Weight-Loss Intervention by Telephone: Lessons Learned

摘要

The dramatic rise in the prevalence of obesity and type 2 diabetes is clearly a strain on health care systems globally (1). Recently published guidelines on obesity management indicate that a sustained weight loss of 3-5% is likely to result in clinically meaningful reductions in triglyc-erides, blood glucose, and A1C (2). However, the 2013 Obesity Guidelines noted achieving more weight loss (approx10%) will also reduce blood pressure, improve LDL cholesterol and HDL cholesterol, and reduce the need for medications required to control cardiometabolic risk (2). The Look AHEAD (Actions for Health in Diabetes) trial provides evidence, specific to diabetes, that an intensive lifestyle intervention can achieve a 5-10% weight loss and can improve sleep apnea quality-of-life indices, achieve cardiometabolic biomarker improvements, and reduce need for medications (3-6). These benefits are emphasized in the 2013 Obesity Guidelines (2). Challenges to providing an intensive intervention in primary care practice setting, as required to achieve the suggested outcomes, include the lack of staffing and resources required to adhere to the schedule for the intensive follow-up.