Skip to main content

Main menu

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • Other Publications
    • abfm

User menu

Search

  • Advanced search
American Board of Family Medicine
  • Other Publications
    • abfm
American Board of Family Medicine

American Board of Family Medicine

Advanced Search

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • JABFM on Bluesky
  • JABFM On Facebook
  • JABFM On Twitter
  • JABFM On YouTube
Review ArticleClinical Review

Diagnosis and Treatment of Obesity in Adults: An Applied Evidence-Based Review

A. John Orzano and John G. Scott
The Journal of the American Board of Family Practice September 2004, 17 (5) 359-369; DOI: https://doi.org/10.3122/jabfm.17.5.359
A. John Orzano
MD, MPH
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
John G. Scott
MD, PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • References
  • Info & Metrics
  • PDF
Loading

References

  1. ↵
    Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 2000; 894:i-xii, 1–253.
  2. ↵
    Mokdad AH, Serdula MK, Dietz WH, Bowman BA, Marks JS, Koplan JP. The spread of the obesity epidemic in the United States, 1991–1998. JAMA 1999; 282: 1519–22.
  3. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J Obes Relat Metab Disord 1998; 22: 39–47.
  4. Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999–2000. JAMA 2002; 288: 1723–7.
  5. ↵
    National Center for Health Statistics. NHANES 1999 Prevalence of overweight and obesity among adults: US, 1999. Hyattsville (MD): US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention; 1999.
  6. ↵
    Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults-The Evidence Report. National Institutes of Health [published erratum appears in Obes Res 1998;6:464]. Obes Res 1998 6 Suppl 2: 51S–209S.
    OpenUrlWeb of Science
  7. ↵
    Palinkas LA, Wingard DL, Barrett-Connor E. Depressive symptoms in overweight and obese older adults: a test of the “jolly fat” hypothesis. J Psychosom Res 1996; 40: 59–66.
    OpenUrlCrossRefPubMedWeb of Science
  8. Desmond SM, Price JH. Self-efficacy and weight control. Health Educ 1988; 19: 12–8.
    OpenUrl
  9. Friedman MA, Brownell KD. Psychological correlates of obesity: moving to the next research generation. Psychol Bull 1995; 117: 3–20.
    OpenUrlCrossRefPubMedWeb of Science
  10. Hill AJ,Williams J.Psychological health in a non-clinical sample of obese women.Int J Obes Relat Metab Disord 1998; 22: 578–83.
    OpenUrlCrossRefPubMedWeb of Science
  11. ↵
    Fontaine KR, Cheskin LJ, Barofsky I. Health-related quality of life in obese persons seeking treatment. J Fam Pract 1996; 43: 265–70.
    OpenUrlPubMedWeb of Science
  12. ↵
    Wolf AM, Colditz GA. The cost of obesity: the US perspective. Pharmacoeconomics 1994; 5(Suppl): 34–7.
    OpenUrl
  13. ↵
    US Preventive Services Task Force. Guide to clinical preventive services: report of the US Preventive Services Task Force, 2nd ed. Baltimore: Williams & Wilkins; 1996.
  14. Blackburn G. Effect of degree of weight loss on health benefits. Obes Res 1995 3 Suppl 2: 211S–6S.
    OpenUrl
  15. ↵
    McTigue KM, Harris R, Hemphill B, et al. Screening and interventions for obesity in adults: summary of the evidence for the US Preventive Services Task Force. Ann Intern Med 2003; 139: 933–49.
    OpenUrlPubMedWeb of Science
  16. ↵
    Green LA, Fryer GE Jr, Yawn BP, Lanier D, Dovey SM. The ecology of medical care revisited. N Engl J Med 2001; 344: 2021–5.
    OpenUrlCrossRefPubMedWeb of Science
  17. ↵
    Noel M, Hickner J, Ettenhofer T, Gauthier B. The high prevalence of obesity in Michigan primary care practices. An UPRNet study. Upper Peninsula Research Network. J Fam Pract 1998; 47: 39–43.
    OpenUrlPubMed
  18. ↵
    Douketis JD, Feightner JW, Attia J, Feldman WF. Periodic health examination, 1999 update: 1. Detection, prevention and treatment of obesity. Canadian Task Force on Preventive Health Care. CMAJ 1999; 160: 513–25.
    OpenUrlAbstract/FREE Full Text
  19. ↵
    Glenny AM, O’Meara S, Melville A, Sheldon TA, Wilson C. The treatment and prevention of obesity: a systematic review of the literature. Int J Obes Relat Metab Disord 1997; 21: 715–37.
    OpenUrlCrossRefPubMedWeb of Science
  20. Harvey EL, Glenny AM, Kirk SF, Summerbell CD. An updated systematic review of interventions to improve health professionals’ management of obesity. Obes Rev 2002; 3: 45–55.
    OpenUrlPubMed
  21. ↵
    Harvey EL, Glenny A, Kirk SF, Summerbell CD. Improving health professionals’ management and the organisation of care for overweight and obese people. Cochrane Database Syst Rev 2001;( 2):CD000984.
  22. ↵
    Heath C, Grant W, Marchetti P, Kamps C. Do family physicians treat obese patients? Fam Med 1993; 25: 401–2.
    OpenUrlPubMed
  23. ↵
    Galuska DA, Will JC, Serdula MK, Ford ES. Are health care professionals advising obese patients to lose weight? JAMA 1999; 282: 1576–8.
  24. ↵
    Hill JO. Dealing with obesity as a chronic disease. Obes Res 1998 6 Suppl 1: 34S–8S.
  25. ↵
    Rippe JM, Crossley S, Ringer R. Obesity as a chronic disease: modern medical and lifestyle management. J Am Diet Assoc 1998; 98(10 Suppl 2): S9–S15.
    OpenUrl
  26. ↵
    Ebrahim S, Smith GD. Systematic review of randomised controlled trials of multiple risk factor interventions for preventing coronary heart disease. BMJ 1997; 314: 1666–74.
    OpenUrlAbstract/FREE Full Text
  27. ↵
    Hill JO, Peters JC. Environmental contributions to the obesity epidemic. Science 1998; 280: 1371–4.
    OpenUrlAbstract/FREE Full Text
  28. ↵
    Manson JE, Willett WC, Stampfer MJ, et al. Body weight and mortality among women. N Engl J Med 1995; 333: 677–85.
    OpenUrlCrossRefPubMedWeb of Science
  29. ↵
    Stamler J, Neaton JD, Wentworth DN. Blood pressure (systolic and diastolic) and risk of fatal coronary heart disease. Hypertension 1989; 13(5 Suppl): I2–I12.
  30. ↵
    Stamler J, Wentworth D, Neaton JD. Is relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded? Findings in 356,222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT). JAMA 1986; 256: 2823–8.
  31. ↵
    Goldstein DJ. Beneficial health effects of modest weight loss. Int J Obes Relat Metab Disord 1992; 16: 397–415.
    OpenUrlPubMedWeb of Science
  32. ↵
    Reisin E, Abel R, Modan M, Silverberg DS, Eliahou HE, Modan B. Effect of weight loss without salt restriction on the reduction of blood pressure in overweight hypertensive patients. N Engl J Med 1978; 298: 1–6.
  33. ↵
    Pi-Sunyer FX. Short-term medical benefits and adverse effects of weight loss. Ann Intern Med 1993; 119: 722–6.
    OpenUrlCrossRefPubMedWeb of Science
  34. ↵
    Wood PD, Stefanick ML, Dreon DM, et al. Changes in plasma lipids and lipoproteins in overweight men during weight loss through dieting as compared with exercise. N Engl J Med 1988; 319: 1173–9.
    OpenUrlPubMedWeb of Science
  35. ↵
    Wing RR, Koeske R, Epstein LH, Nowalk MP, Gooding W, Becker D. Long-term effects of modest weight loss in type II diabetic patients. Arch Intern Med 1987; 147: 1749–53.
    OpenUrlCrossRefPubMedWeb of Science
  36. ↵
    Garrow J. Christmas factor and snacking. Lancet 2000; 355: 8.
    OpenUrlPubMed
  37. ↵
    Karlsson J, Sjostrom L, Sullivan M. Swedish obese subjects (SOS)–an intervention study of obesity. Two- year follow-up of health-related quality of life (HRQL) and eating behavior after gastric surgery for severe obesity. Int J Obes Relat Metab Disord 1998; 22: 113–26.
    OpenUrlCrossRefPubMedWeb of Science
  38. ↵
    Karason K, Lindroos AK, Stenlof K, Sjostrom L. Relief of cardiorespiratory symptoms and increased physical activity after surgically induced weight loss: results from the Swedish Obese Subjects study. Arch Intern Med 2000; 160: 1797–802.
    OpenUrlCrossRefPubMedWeb of Science
  39. ↵
    Hollander PA, Elbein SC, Hirsch IB, et al. Role of orlistat in the treatment of obese patients with type 2 diabetes. A 1-year randomized double-blind study. Diabetes Care 1998; 21: 1288–94.
  40. ↵
    Stamler R, Stamler J, Grimm R, et al. Nutritional therapy for high blood pressure. Final report of a four- year randomized controlled trial-the Hypertension Control Program. JAMA 1987; 257: 1484–91.
  41. ↵
    Langlois JA, Harris T, Looker AC, Madans J. Weight change between age 50 years and old age is associated with risk of hip fracture in white women aged 67 years and older. Arch Intern Med 1996; 156: 989–94.
    OpenUrlCrossRefPubMedWeb of Science
  42. ↵
    Weight cycling. National Task Force on the Prevention and Treatment of Obesity. JAMA 1994; 272: 1196–202.
  43. ↵
    Harvey EL, Glenny AM, Kirk SF, Summerbell CD. A systematic review of interventions to improve health professionals’ management of obesity. Int J Obes Relat Metab Disord 1999; 23: 1213–22.
    OpenUrlCrossRefPubMedWeb of Science
  44. ↵
    Pignone MP, Ammerman A, Fernandez L, et al. Counseling to promote a healthy diet in adults: a summary of the evidence for the U.S. Preventive Services Task Force. Am J Prev Med 2003; 24: 75–92.
    OpenUrlCrossRefPubMedWeb of Science
  45. ↵
    Smith IG, Goulder MA. Randomized placebo- controlled trial of long-term treatment with sibutramine in mild to moderate obesity. J Fam Pract 2001; 50: 505–12.
    OpenUrlPubMedWeb of Science
  46. ↵
    Glazer G. Long-term pharmacotherapy of obesity 2000: a review of efficacy and safety. Arch Intern Med 2001; 161: 1814–24.
    OpenUrlCrossRefPubMedWeb of Science
  47. Hill JO, Hauptman J, Anderson JW, et al. Orlistat, a lipase inhibitor, for weight maintenance after conventional dieting: a 1-y study. Am J Clin Nutr 1999; 69: 1108–16.
    OpenUrlAbstract/FREE Full Text
  48. ↵
    Sjostrom L, Rissanen A, Andersen T, et al. Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. European Multicentre Orlistat Study Group. Lancet 1998; 352: 167–72.
    OpenUrlCrossRefPubMedWeb of Science
  49. Hauptman J, Lucas C, Boldrin MN, Collins H, Segal KR. Orlistat in the long-term treatment of obesity in primary care settings. Arch Fam Med 2000; 9: 160–7.
    OpenUrlCrossRefPubMedWeb of Science
  50. McMahon FG, Fujioka K, Singh BN, et al. Efficacy and safety of sibutramine in obese white and African American patients with hypertension: a 1-year, double-blind, placebo-controlled, multicenter trial. Arch Intern Med 2000; 160: 2185–91.
    OpenUrlCrossRefPubMedWeb of Science
  51. James WP, Astrup A, Finer N, et al. Effect of sibutramine on weight maintenance after weight loss: a randomised trial. STORM Study Group. Sibutramine Trial of Obesity Reduction and Maintenance. Lancet 2000; 356: 2119–25.
    OpenUrlCrossRefPubMedWeb of Science
  52. Finer N, Bloom SR, Frost GS, Banks LM, Griffiths J. Sibutramine is effective for weight loss and diabetic control in obesity with type 2 diabetes: a randomised, double-blind, placebo-controlled study. Diabetes Obes Metab 2000; 2: 105–12.
    OpenUrlCrossRefPubMedWeb of Science
  53. ↵
    NHS Centre for Reviews and Dissemination. The prevention and treatment of obesity. Effective Health Care 1997; 3.
  54. ↵
    O’Meara S, Glenny AM, Wilson C, Melville A, Sheldon TA. Effective management of obesity. Qual Health Care 1997; 6: 170–5.
    OpenUrlFREE Full Text
  55. ↵
    National Guideline Clearinghouse [database on the Internet]. Rockville (MD): Agency for Healthcare Research and Quality; 2004 [cited 2004 Jul 28]. Available from http://www.guideline.gov/search/searchresults.aspx?Type=3&txtsearch=obesity&num=20
  56. ↵
    National Guideline Clearinghouse [homepage on the Internet]. Washington DC: US Department of Health and Human Services, Agency for Healthcare Quality and Research; 2004 [updated 2004 Jul 12; cited 2004 July 19]. Available from: http://www.guideline.gov.
  57. ↵
    Segal KR, Dunaif A, Gutin B, Albu J, Nyman A, Pi-Sunyer FX. Body composition, not body weight, is related to cardiovascular disease risk factors and sex hormone levels in men. J Clin Invest 1987; 80: 1050–5.
  58. ↵
    Curtin F, Morabia A, Pichard C, Slosman DO. Body mass index compared to dual-energy x-ray absorptiometry: evidence for a spectrum bias. J Clin Epidemiol 1997; 50: 837–43.
    OpenUrlCrossRefPubMedWeb of Science
  59. Smalley KJ, Knerr AN, Kendrick ZV, Colliver JA, Owen OE. Reassessment of body mass indices. Am J Clin Nutr 1990; 52: 405–8.
    OpenUrlAbstract/FREE Full Text
  60. Frankenfield DC, Rowe WA, Cooney RN, Smith JS, Becker D. Limits of body mass index to detect obesity and predict body composition. Nutrition 2001; 17: 26–30.
    OpenUrlCrossRefPubMedWeb of Science
  61. ↵
    Logue E, Gilchrist V, Bourguet C, Bartos P. Recognition and management of obesity in a family practice setting. J Am Board Fam Pract 1993; 6: 457–63.
  62. ↵
    Taylor RW, Keil D, Gold EJ, Williams SM, Goulding A. Body mass index, waist girth, and waist-to-hip ratio as indexes of total and regional adiposity in women: evaluation using receiver operating characteristic curves. Am J Clin Nutr 1998; 67: 44–9.
    OpenUrlAbstract
  63. ↵
    FSHimmel W, Stolpe C, Kochen M. Information and communication about overweight in family practice. Fam Pract Res J 1994; 14: 339–51.
    OpenUrlPubMed
  64. ↵
    O’Meara S, Riemsma R, Shirran L, Mather L, ter Riet G. A rapid and systematic review of the clinical effectiveness and cost-effectiveness of orlistat in the management of obesity. Health Technol Assess 2001; 5(18): 1–81.
    OpenUrl
  65. ↵
    Skender ML, Goodrick GK, Del Junco DJ, et al. Comparison of 2-year weight loss trends in behavioral treatments of obesity: diet, exercise, and combination interventions. J Am Diet Assoc 1996; 96: 342–6.
    OpenUrlCrossRefPubMedWeb of Science
  66. ↵
    Davidson MH, Hauptman J, DiGirolamo M, et al. Weight control and risk factor reduction in obese subjects treated for 2 years with orlistat: a randomized controlled trial. JAMA 1999; 281: 235–42.
  67. ↵
    Yanovski SZ, Yanovski JA. Obesity. N Engl J Med 2002; 346: 591–602.
    OpenUrlCrossRefPubMedWeb of Science
  68. ↵
    Heymsfield SB, Allison DB, Vasselli JR, Pietrobelli A, Greenfield D, Nunez C. Garcinia cambogia (hydroxycitric acid) as a potential antiobesity agent: a randomized controlled trial. JAMA 1998; 280: 1596–600.
  69. ↵
    Request for the immediate ban of Meridia (sibutramine).Washington DC: US Food and Drug Administration. Available from: http://www.fda.gov/ohrms/dockets/dailys/02/Mar02/032202/02p-0120_cp00001_vol1.pdf.
  70. ↵
    Hauptman JB, Jeunet FS, Hartmann D. Initial studies in humans with the novel gastrointestinal lipase inhibitor Ro 18-0647 (tetrahydrolipstatin). Am J Clin Nutr 1992; 55(1 Suppl): 309S–13S.
    OpenUrl
  71. ↵
    Andersen T, Stokholm KH, Backer OG, Quaade F. Long-term (5-year) results after either horizontal gastroplasty or very- low-calorie diet for morbid obesity. Int J Obes 1988; 12: 277–84.
    OpenUrlPubMedWeb of Science
  72. ↵
    Hall JC, Watts JM, O’Brien PE, et al. Gastric surgery for morbid obesity. The Adelaide Study. Ann Surg 1990; 211: 419–27.
    OpenUrlPubMedWeb of Science
  73. Naslund I, Wickbom G, Christoffersson E, Agren G. A prospective randomized comparison of gastric bypass and gastroplasty. Complications and early results. Acta Chir Scand 1986; 152: 681–9.
    OpenUrlPubMedWeb of Science
  74. Lechner GW, Elliott DW. Comparison of weight loss after gastric exclusion and partitioning. Arch Surg 1983; 118: 685–92.
    OpenUrlCrossRefPubMed
  75. Ashley S, Bird DL, Sugden G, Royston CM. Vertical banded gastroplasty for the treatment of morbid obesity. Br J Surg 1993; 80: 1421–3.
    OpenUrlPubMed
  76. ↵
    Wagner EH, Groves T. Care for chronic diseases.BMJ 2002; 325: 913–4.
    OpenUrlFREE Full Text
  77. ↵
    French SA, Story M, Jeffery RW. Environmental influences on eating and physical activity. Annu Rev Public Health 2001; 22: 309–35.
    OpenUrlCrossRefPubMedWeb of Science
  78. Wadden TA, Stunkard AJ. Controlled trial of very low calorie diet, behavior therapy, and their combination in the treatment of obesity. J Consult Clin Psychol 1986; 54: 482–8.
    OpenUrlCrossRefPubMedWeb of Science
PreviousNext
Back to top

In this issue

The Journal of the American Board of Family Practice: 17 (5)
The Journal of the American Board of Family Practice
Vol. 17, Issue 5
1 Sep 2004
  • Table of Contents
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Board of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Diagnosis and Treatment of Obesity in Adults: An Applied Evidence-Based Review
(Your Name) has sent you a message from American Board of Family Medicine
(Your Name) thought you would like to see the American Board of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
2 + 6 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Diagnosis and Treatment of Obesity in Adults: An Applied Evidence-Based Review
A. John Orzano, John G. Scott
The Journal of the American Board of Family Practice Sep 2004, 17 (5) 359-369; DOI: 10.3122/jabfm.17.5.359

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Diagnosis and Treatment of Obesity in Adults: An Applied Evidence-Based Review
A. John Orzano, John G. Scott
The Journal of the American Board of Family Practice Sep 2004, 17 (5) 359-369; DOI: 10.3122/jabfm.17.5.359
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Background
    • Methods
    • Results
    • Discussion
    • Notes
    • References
  • Figures & Data
  • References
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Role of the family doctor in the management of adults with obesity: a scoping review
  • Epicatechin, procyanidins, cocoa, and appetite: a randomized controlled trial
  • Simulating the impact of changing trends in smoking and obesity on productivity of an industrial population: an observational study
  • Combination Diet and Exercise Interventions for the Treatment of Dyslipidemia: an Effective Preliminary Strategy to Lower Cholesterol Levels?
  • Google Scholar

More in this TOC Section

  • Interpretating Normal Values and Reference Ranges for Laboratory Tests
  • Non-Surgical Management of Urinary Incontinence
  • Screening and Diagnosis of Type 2 Diabetes in Sickle Cell Disease
Show more Clinical Review

Similar Articles

Navigate

  • Home
  • Current Issue
  • Past Issues

Authors & Reviewers

  • Info For Authors
  • Info For Reviewers
  • Submit A Manuscript/Review

Other Services

  • Get Email Alerts
  • Classifieds
  • Reprints and Permissions

Other Resources

  • Forms
  • Contact Us
  • ABFM News

© 2025 American Board of Family Medicine

Powered by HighWire