Obesity: Lifestyle Modification and Behavior Interventions.

Lifestyle modifications are first-line therapy for patients with overweight or obesity. The most effective weight loss intervention is one that includes a moderately reduced-calorie diet, increased physical activity, and the use of behavior strategies to facilitate adherence. The goal should be a modest weight loss of 5% to 10% that can be maintained long term. Although individual studies have identified specific benefits associated with certain diets, no diet has been shown to be more effective than another. For substantial health benefits, adults should engage in at least 150 to 300 min/week of moderate-intensity or 75 to 150 min/week of vigorous-intensity aerobic physical activity. Effective behavior strategies include the combination of motivational interviewing and cognitive behavior therapy. Other strategies include removal of environmental trigger foods, self distraction to help with cravings and boredom eating, and planning ahead. It is critical that children and adolescents avoid dieting or other consciously restrictive behaviors because these have been associated with weight gain and binge eating. Rather than weight, discussions with children and adolescents should focus on achieving and maintaining a healthy lifestyle. Physical activity should be encouraged from childhood through young adulthood.