An effective approach to obesity treatment however must first recognize that obesity is a chronic and often progressive disease. For those patients who have been in a pattern of weight gain over time, the first goal is not weight loss, but weight stabilization (i.e., the prevention of further weight gain).
Once weight has been effectively stabilized weight loss can be approached as the next step. Because patient expectations often drastically exceed achievable results, it is important to have a full discussion to set realistic behavioural goals that will confer health benefits and reduced risks. Even a weight-loss of 5% is clinically significant, with the potential to substantially reduce risk of comorbidities.
Meta-analysis shows current weight-management interventions in primary care are not effective over the long term, achieving a mean weight loss of less than 1.5 kg at 12 and 24 months. A recognition of obesity as a chronic disease requiring lifelong intervention, placing a focus on maintenance of weight loss and improvement in health behaviours over the long term is critical to the success of treatment.
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