Counseling Can Prevent Obesity in Normal, Overweight Women

MONDAY, Aug. 1, 2022 — Midlife women with normal or overweight body mass index (BMI) should undergo counseling to maintain weight or limit weight gain in order to prevent obesity, according to a clinical guideline issued by the Women’s Preventive Services Initiative (WPSI) and published online Aug. 2 in the Annals of Internal Medicine.

Amy G. Cantor, M.D., M.P.H., from Pacific Northwest Evidence-based Practice Center in Portland, Oregon, and colleagues conducted a systematic review to examine evidence on the effectiveness and harms of behavioral interventions to reduce weight gain and improve health outcomes among women aged 40 to 60 years without obesity. Data were included from seven randomized controlled trials (RCTs) in 12 publications, with 51,638 participants. The researchers found statistically significant favorable differences in weight change for counseling interventions versus control groups in four RCTs, whereas no differences were seen in one trial of counseling and two trials of exercise. One of two RCTs reported improvement in quality-of-life measures. Measures of depression or stress were not increased with interventions in one trial; in one trial, self-reported falls and injuries were higher with exercise counseling.

Based on these findings, David Chelmow, M.D., from the Virginia Commonwealth University School of Medicine in Richmond, and colleagues developed recommendations for counseling midlife women aged 40 to 60 years with normal or overweight BMI for the WPSI. The WPSI recommends counseling midlife women with normal or overweight BMI (18.5 to 29.9 kg/m2) to maintain weight or limit weight gain. Counseling could include individualized discussion of healthy eating and physical activity.

“Although the optimal approach could not be discerned from existing trials, a range of interventions of varying duration, frequency, and intensity showed benefit with potential clinical significance,” Chelmow and colleagues write.

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