Intensive lifestyle intervention for obesity: principles, practices, and results.
Abstract
Using the Guidelines for the Management of Overweight and Obesity in Adults as a framework, this article reviews intensive lifestyle interventions for weight loss. The Guidelines recommend a minimum of 6 months of high-intensity, comprehensive lifestyle intervention, consisting of a reduced-calorie diet, increased physical activity, and behavior therapy. Persons with obesity typically lose approximately 8 kg (approximately 8% of initial weight) with this approach, accompanied by improvements in health and quality of life. To prevent weight regain, the Guidelines recommend a 1-year weight loss maintenance program that includes at least monthly counseling with a trained interventionist. Lifestyle interventions usually are delivered in-person; however, treatment increasingly is being disseminated through community- and commercial-based programs, as well as delivered by telephone, Internet, and smartphone platforms. These latter modalities expand treatment reach but usually produce smaller weight losses than in-person interventions. The review concludes with an examination of challenges in weight management.
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The addition of semaglutide to intensive behavioral therapy may help patients achieve more than the average 5% to 10% reduction in body weight typically produced by behavioral interventions at 6 to 12 months.
“The present findings suggest that the addition of semaglutide to intensive behavioral therapy may help patients achieve more than the average 5% to 10% reduction in body weight typically produced by behavioral interventions at 6 to 12 months.1,21”
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Behavioral Treatment of the Patient with Obesity
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Wadden, T. A., Bailey, T. S., Billings, L. K., Davies, M., Frias, J. P., Koroleva, A., Lingvay, I., O’Neil, P. M., Rubino, D. M., Skovgaard, D., et al. (2021) · JAMA · doi:10.1001/jama.2021.1831 · Cited by 1,114 · see citing works
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Self-citationDisparities in Access and Quality of Obesity Care
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- Authors
- Webb, V. L., & Wadden, T. A.
- Affiliations
- Yale University (US)
- University of Pennsylvania (US)
- Corresponding author
- Wadden, Thomas A.
- ORCID
- Wadden, Thomas A.
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2017-05
- Volume
- 152
- Issue
- 7
- Pages
- 1752-1764
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W2587507832
- Cited by
- 167
- References
- 108
- Citations by year
- 2026: 11 · 2025: 23 · 2024: 14 · 2023: 17 · 2022: 18 · 2021: 23 · 2020: 22 · 2019: 16 · 2018: 14 · 2017: 8 · 2013: 1
- FWCI
- 2.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Keywords
- obesity, intensive lifestyle intervention, weight loss, hypocaloric diet, physical activity, behavior therapy, weight regain prevention, weight loss maintenance, telemedicine, smartphone-based intervention, quality of life
- MeSH terms
- Body Weight Maintenance, Behavior Therapy, Delivery of Health Care, Diet, Exercise Therapy, Humans, Life Style, Obesity, Telephone, Internet, Caloric Restriction, Directive Counseling, Weight Reduction Programs, Mobile Applications
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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