Successful Weight Loss: Evidence-Based Obesity Resources Overweight and obese individuals often find it difficult to lose weight and keep it off. Health care providers are uniquely positioned to engage in a dialogue with these patients about their weight and the health risks associated with it. By building a partnership, health care providers can help individuals develop weight loss goals that they can achieve and sustain. Practical, evidence-based strategies and tools that are based on research supported by the National Heart, Lung, and Blood Institute (NHLBI) are available for clinicians, patients, and the general public to prevent or treat overweight and obesity. Contents Background
Obesity is characterized as having an excess amount of body fat. The most common measure used in clinical practice to approximate body fat is body mass index (BMI). BMI is a measure of weight relative to height and can be calculated for adults, children, and teens. In adults, obesity is defined as a BMI of 30 kilograms/meters2 (kg/m2) or greater. In children and teens, it’s defined as a BMI at or greater than the 95th percentile for age and gender, based on national growth charts. - Learn more about the diagnosis of overweight and obesity
- Calculate BMI (applies to adult men and women)
- Download the BMI Calculator App (for iPhone)
Being overweight or obese can raise a person’s risk for a number of diseases and conditions, including cardiovascular disease (CVD); high blood pressure; stroke; type 2 diabetes; abnormal levels of blood fats such as cholesterol and triglycerides; metabolic syndrome; colon, breast, endometrial, and gallbladder cancers; osteoarthritis; sleep apnea; and gallstones. Children and teens who are overweight or obese are more likely to become overweight or obese as adults, with the same disease risks, and may additionally suffer low self-esteem, isolation, and eating disorders.
Learn more about the health risks of obesity Obesity generally stems from a lack of energy balance in which the calories consumed from food and beverages are greater than the calories burned for basic functions such as breathing and digesting, normal growth, and physical activity. Many factors influence this balance, including a person’s behavior, environment, metabolism, and genes.
Learn more about energy balance and estimated calorie requirements Obesity Research
The Strategic Plan for NIH Obesity Research was published in March 2011 to encourage diverse scientific studies to combat the U.S. obesity epidemic. This new plan reflects the advances and opportunities that have emerged since the National Institutes of Health (NIH) published the first plan in 2004. The plan identifies a range of research opportunities to continue the search for the causes of obesity, develop effective and practical interventions for prevention and treatment, reduce health disparities, and inform policy. Susan B. Shurin, M.D., acting director of the NHLBI, is one of three cochairs for the NIH Obesity Research Task Force, which developed the plan with input from scientists external to the NIH, health professionals, and the public. The NHLBI is one of several organizations that is partnering to address the problem of childhood obesity in America through the National Collaborative on Childhood Obesity Research (NCCOR). NCCOR is focusing on efforts that have the potential to benefit children, teens, and their families, as well as the communities in which they live. A special emphasis is being placed on the populations and communities in which obesity rates are highest and rising the fastest. The NHLBI has funded extensive research that has contributed to understanding the causes, complications, and treatment of overweight and obesity. Ongoing studies focus on a wide range of topics that include: - The effects of obesity on morbidity and mortality
- The effects of childhood obesity on future health
- The effects of weight loss on cardiovascular disease risk factors
- The identification of factors associated with obesity
- The efficacy of interventions on the prevention of weight gain, weight loss, and weight loss maintenance
- The effectiveness of interventions in communities, schools, work sites, and clinical practice settings
Examples of previous and current NHLBI-supported studies can be found at the NHLBI Obesity Research Web site. They include: - Coronary Artery Risk Development in Young Adults (CARDIA)
This large, multicenter observational study began in 1983 with the goal of examining the development and determinants of cardiovascular disease and its risk factors in more than 5,000 healthy Black and White men and women aged 18–30 years. Data have been collected on a variety of factors related to heart disease (blood pressure, cholesterol and other lipids), as well as on physical measurements (weight, skinfold fat), lifestyle factors (tobacco and alcohol use), dietary and exercise patterns, behavioral and psychological variables, and medical and family history.
Participants have now been followed for more than 20 years. As these individuals have transitioned from young adulthood to middle age, additional measurements are enabling the study of the development and consequences of obesity, as well as other diseases and conditions such as diabetes and vascular diseases.
Learn more about the CARDIA study - Early Adult Reduction of weight through LifestYle intervention (EARLY) Trials
These seven trials are seeking to prevent weight gain and promote weight loss among young adults, aged 18–35 years, and are translating some of the lessons learned from the CARDIA study. Participants, who are at high risk for weight gain, include pregnant and postpartum women, community college or university students, and young adults trying to quit smoking. The trials are testing technology-driven behavioral approaches for weight control through healthy eating and physical activity.
Learn more about the EARLY Trials - Preventing Overweight Using Novel Dietary Strategies (POUNDS LOST)
This clinical trial compared the effects of four heart healthy diets that varied in their fat, protein, and carbohydrate composition on weight loss and weight loss maintenance in more than 800 overweight or obese adults aged 30–70 years. All participants lost weight, maintained the majority of the weight loss after 2 years, and improved their cardiovascular disease risk factors. The trial showed that heart healthy, reduced-calorie diets, regardless of the macronutrients emphasized, can help overweight and obese adults achieve and maintain weight loss.
Review a summary of POUNDS LOST - Healthy Communities Study (HCS)
This 5-year observational study will examine more than 275 communities and 23,000 children, aged 3–15 years, to identify characteristics of community programs and policies that are related to lower childhood obesity rates and better eating and activity behaviors. The study aims to (1) determine the associations between community programs/policies and BMI, diet, and physical activity in children; and (2) identify the community, family, and child factors that modify or mediate the associations between community programs/policies and BMI, diet, and physical activity in children.
The study will examine quantitative and qualitative information obtained from community-based initiatives, community characteristics (e.g., school environment), child and parent assessments and measurements of children’s physical activity levels, dietary practices of children, and children’s and parent’s BMI.
Learn more about the HCS Clinical Trial Participation
The NHLBI has an exciting and extensive array of clinical trials that are currently enrolling lean, overweight, and obese children, teens, and adults. There are trials for pregnant and postpartum women, for young adults who are trying to quit smoking, and for obese adults with sleep apnea or poorly controlled asthma. There are clinical trials that take place at the workplace, that are church-based, and that are part of college curricula. Some trials are using technology such as text messaging, online social networking, and Bluetooth-enabled scales, while others are using supervised nutritional counseling and daily exercise programs. Health care providers can encourage and guide patients to enroll. Individuals can talk with their doctors about relevant trials near them.
Learn more about ongoing clinical trials Translating Science Into Practice: Evidence-Based Prevention and Treatment Strategies
The depth and breadth of research supported by the NHLBI has led to practical, evidence-based strategies and tools for clinicians, patients, and the general public that can lead to improved health care and policies. - We Can!® (Ways to Enhance Children's Activity & Nutrition) is a national movement designed to give parents, caregivers, and entire communities a way to help children aged 8–13 years stay at a healthy weight. Four NIH institutes, led by the NHLBI, have come together to combine unique resources and activities to bring you the We Can! program.
Because parents often turn to health professionals for accurate information and guidance regarding their child's health, We Can! offers extensive resources for physicians and other health professionals, including information on how to enhance children's activity, promote healthy eating, and reduce screen time.
Health professionals are encouraged to refer parents and caregivers to We Can! for additional information and community programs; to get involved with one of the more than 1,500 local We Can! community sites; and to foster partnerships between professional organizations and We Can! - Aim for a Healthy Weight resources include clinical practice guidelines on assessing weight and health risk; information on losing and controlling weight, including a guide to behavior change; advice and resources on eating right and being physically active; and healthy weight tools such as a BMI calculator and menu planner.
- An update of the evidence-based Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults is in development and is expected to be available for public review and comment in 2011.
Key Steps for Health Professionals - Identity at-risk individuals and help them understand that even modest weight loss (5–10 percent) can lead to clinically important reductions in disease risk factors.
- Encourage individuals to:
- Adopt healthy lifestyle behaviors (balance calories consumed with calories burned).
- Make healthy food choices, engage in regular physical activity, and spend less time in sedentary activities such as watching television or computer games.
- Work closely with health care providers to monitor and treat potential health effects of overweight or obesity.
- Encourage community efforts that support healthy nutrition, reduce sedentary time, and increase physical activity.
- Encourage enrollment in clinical trials.
Popular NHLBI Materials NHLBI Obesity Resources - “Overweight and Obesity” From the NHLBI Diseases and Conditions Index (DCI)
- NHLBI Obesity Research Web site
- Strategic Plan for NIH Obesity Research
- NIH Director Dr. Francis Collins discusses the Strategic Plan for NIH Obesity Research (video)
- NIH obesity research funding opportunities
- Simons-Morton, D.G., Donato, K., Loria, C.M., et al. Obesity research and programs at the National Heart, Lung, and Blood Institute. Journal of the American College of Cardiology, 2010 Mar 2;55(9):917–20.
- Trials use technology to help young adults achieve healthy weights (NIH news release)
- Virtual Reality Technologies for Research and Education in Obesity and Diabetes, NHLBI Working Group report, NIH, HHS (2010)
Other Resources - The Weight-control Information Network, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH
- ChooseMyPlate.gov, United States Department of Agriculture (USDA)
- Dietary Guidelines for Americans, 2010 (USDA)
- Let’s Move Initiative
July 2011 ® We Can! Ways to Enhance Children's Activity & Nutrition, We Can!, and the We Can! logos are registered trademarks of the U.S. Department of Health and Human Services (HHS). |
