Management of Adult Overweight and Obesity (OBE)

Publication Date: June 30, 2020
Last Updated: March 3, 2023

Objective

Objective

This patient summary means to discuss key recommendations from the Department of Veterans Affairs, the Department of Defense, for the management of adult overweight and obesity. This patient summary is limited to adults 18 years of age and older and should not be used as a reference for children.

Overview

Overview

  • Obesity is a medical condition with numerous serious medical consequences.
  • Obesity is caused by consuming more calories than are used for the body’s energy needs.
    • Energy needs vary among individuals, but reducing caloric intake can always reduce weight.
  • This patient summary focuses on methods to reduce weight and the medical consequences.

Diagnosis

Diagnosis

  • “Overweight” is based on extensive data relating the percentage of body fat to overall health.
  • The health risk is apportioned by degrees according to several scales.
    • The most common is body mass index (BMI), which is weight compared to body surface area in mg/m2.
      • “Overweight" is a BMI between 25 and 30.
      • Class I Obesity is a BMI between 30 and 35.
      • Class II Obesity is a BMI between 35 and 40.
      • Class III Obesity is a BMI over 40.
    • Other measurement systems include:
      • waist circumference
      • skinfold thickness
      • body fat determined by CT (or MRI or dual X-ray absorptiometry)
      • body specific gravity determined by floating in water
      • bioelectrical impedance

Treatment

Treatment

  • The VA recommends individual comprehensive lifestyle intervention including behavioral, dietary, and physical activity components for both weight loss and weight maintenance.
    • May be managed either in person or by telecommunication.
    • The physical activity component may be aerobic, resistance and/or lifestyle physical activity.
  • Drug treatment may include:
    • liraglutide
    • naltrexone/bupropion
    • orlistat OR
    • phentermine/topiramate
  • Metabolic/bariatric surgery is an option for you if you have:
    • type 2 diabetes
    • BMI over 40
    • Obesity-related conditions
  • Gastric balloons are an option for short-term (up to six months) weight loss.

Abbreviations

  • BMI: Body Mass Index
  • CT: Computed Tomography
  • MRI: Magnetic Resonance Imaging
  • OBE: Obesity
  • VA: Veterans Administration
  • mg/kg: Milligrams Per Kilogram

Source Citation

Mayer SB, Graybill S, Raffa SD, Tracy C, Gaar E, Wisbach G, Goldstein MG, Sall J. Synopsis of the 2020 U.S. VA/DoD Clinical Practice Guideline for the Management of Adult Overweight and Obesity. Mil Med. 2021 Aug 28;186(9-10):884-896. doi: 10.1093/milmed/usab114. PMID: 33904926.

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.